bluuebunny/crossref_metadata_2025 huggingface dataset:
Wellbeing of staff teams
Authors: Taylor Lorna
Published: May 2014

Back problems have long been considered an occupational hazard for early years educators. Lorna Taylor, explains why it should not be ignored and suggests ideas to help practitioners and employers.
The wonder of being two
Authors: Lee Maureen
Published: May 2014

So, just what are the joys and challenges of working with two-year-olds, and what are the professional development implications for practitioners who might be providing for this age group for the first time?
From page to practice
Authors: Brown Paula
Published: May 2014

Critical reflective practice, perhaps stored in a personal journal, coupled with sound knowledge of child development and awareness of personal values and beliefs, contribute to excellent practice.
When allergens attack
Authors: Day Lin
Published: May 2014

The late blossoming of spring this year has witnessed a pollen explosion, causing allergy sufferers much misery, but this is not the only type of allergen that nursery workers need to be aware of in their setting.
A setting for language
Authors: Busani Beth
Published: May 2014

This article describes the results and benefits of language and social communication training for early years practitioners, working to boost communication skills with two to three-year-olds in South Wales.
So, where do we go from here?
Authors: Leitch Neil
Published: May 2014

The government has finally decided not to implement the relaxation of childcare ratios in English settings from September, which is positive news, but what is next for the sector, asks Neil Leitch?
Swing while you sing
Authors: Clarke Jenni
Published: May 2014

The last of our series for practitioners working in baby rooms or with very young children explores how to introduce activities that offer a sensation of swinging and movement, and all with a song!
Thrilling, willing, skills
Authors: Bryce-Clegg Alistair
Published: May 2014

The second part of a 12-month series, that will explore creating effective learning environments for early learning, explores the benefits of auditing your play areas to see whether they are fit for purpose.
The world in our hands
Authors: Finlayson Keri
Published: May 2014

The final article in our series, that has looked at sequencing skills in the areas of learning of the Early Years Foundation Stage, examines how we understand our world, and the very concept of time itself.
Leuven wellbeing scales
Authors: Barber Jenny
Published: May 2014

A child's wellbeing is intrinsically linked to levels of motivation to learn and their involvement, which can also be used to assess the quality of provision and adult support offered in an early years setting..
Bring policy makers to the table
Authors: Fielden Deborah
Published: May 2014

The government has been ideologically moving away from childcarers since it came to power, but the sector is trying to engage with key policy makers to put children back at the heart of the early years.
Agency trials set to reveal all
Authors: Robb Sue
Published: May 2014

The trials of childminder agencies have begun amid widespread concern and anger in the sector, but much will be learnt by observing how they work in practice and the experience of the triallists.
Don't be afraid of heights!
Authors: Horvath Judit
Published: May 2014

In the fourth of a six-part series, Don't be afraid of… Judit Horvath explores some unusual, lesser-used resources. This article highlights the many possibilities offered by giving children opportunities to climb.
Going beyond quality
Authors: Moss Peter
Published: May 2014

Government and practitioners demand that our early education systems have ‘quality’, but what do we mean by this term and do we fully understand its connotations? Do we even need it at all?
The teacher standards
Authors: Lee Maureen
Published: May 2014

The Teachers' Standards (Early Years) – a distinctive set of professional expectations – have now been officially launched and the first cohorts of students are working towards it, but are they fit for purpose?
How a child learns to talk
Authors: Jones Michael
Published: May 2014

In this 12-part series, we will explore the development of language and communication from birth to three-years-old – the most crucial stage – at a time when more two-year-olds are entering nurseries.
What we can learn from… Diwali
Authors: Chapman Ailsa
Published: May 2014

This month, we are focusing on the topic of Diwali, a joyous and colourful festival, which is also known as The Festival of Lights, and which is celebrated by millions of people around the world.
Building strong bridges
Authors: Sharpe Deborah
Published: May 2014

Humans have been building raised routes across rivers, canyons and valleys since time immemorial, and the engineering feats involved, in even simple structures make for great learning activities for children.
Babies and vaccinations
Authors: Day Lin
Published: May 2014

A child's health is often at its most vulnerable in the first months after birth, which is why it so important to maintain a vaccination programme, which has seen infections from disease continue to fall for years.
Defining professional
Authors: Bamsey Victoria
Published: May 2014

Work on behalf of Devon County Council examined whether professionalism in the early years is solely determined by policy or can individuals be seen as professional without government say-so?
Being positive and honest
Authors: Horvath Judit
Published: May 2014

Self-evaluation should not simply be a process that results in completing an Ofsted form, when used regularly, it can help to improve standards in your setting and help to drive professional development.
Cards are for learning
Authors: Leeper Marion
Published: May 2014

Christmas is a time that lends itself to activities of all kinds, especially those of an arts and crafts variety, but we do not want to send children home with identikit products, that involve no skill in the making.
Crying for good reason
Authors: Day Lin
Published: May 2014

It is something that all babies do, and it can convey one of many emotions and occur for any number of reasons, the secret is knowing which is which. Here we look at some of the most common causes.
A register for nannies is needed
Authors: Pritchard Tricia
Published: May 2014

During high-level conversations between members of the Regulation Matters campaign and Skills Active, it was decided to investigate the feasibility of setting up a self-funded Register for Nannies.
What we can learn from… Pirates!
Authors: Chapman Ailsa
Published: May 2014

This month, we take a look at one of the most popular topics or themes for young children – Pirates – and offer a number of starting points that can easily be used for fun, early years learning activities.
Songs about animals
Authors: Harries Judith
Published: May 2014

The second article in our series, exploring how music describes different topics, looks at animals. There are many well-known songs that can be used to inspire fun activities, across all areas of the early years.
Connecting with communities
Authors: Hassall Annamarie
Published: May 2014

Annamarie Hassall looks at the importance of engagement in creating local services that pull together professional bodies, councils and the communities they serve to bring about beneficial, lasting change.
A lack of joined-up thinking
Authors: Lawson Deborah
Published: May 2014

For every positive statement on the subject of childcare and early education made by this government, there are a number of areas that remain of concern, and that show little in the way of progressive policy.
Consultations process flawed
Authors: Leitch Neil
Published: May 2014

Government plans to introduce an early years pupil premium are welcome, but despite an intention to consult on the details, the fact a budget has been set shows that most of the decisions have been made.
What does it mean to me?
Authors: Dubiel Jan
Published: May 2014

Amid a recent policy flood from the education department and from Ofsted it can be hard to remember that you, as practitioners, are the interpreters of guidance and terminology; this makes you powerful.
Inspiring talk outdoors
Authors: Jones Michael
Published: May 2014

In the eighth article in our series on communication from birth to three, we explore how children find it easier to talk when they have something interesting to chat about in engaging environments.
Connecting to nature
Authors: Jefferies Tina , Burton Anita
Published: May 2014

We know that most children love to be outdoors and that being immersed in nature can have both health and learning benefits, but how do we ensure that all of our staff members feel the same?
Confronting the Big C
Authors: Cruft Claire
Published: May 2014

Claire Cruft, senior schools and youth programme manager for Macmillan Cancer Support, explores the importance of discussing cancer openly with children and ensuring adequate support is in place.
Citizens with developmental rights
Authors: Ellyatt Wendy
Published: May 2014

The Save Childhood Movement is calling for early years policy making to be put in the hands of a nonpolitical and multi-disciplinary council that will act as an evidence-based guidance body to government.
Fruit of the magic tree
Authors: Leeper Marion
Published: May 2014

Early years practitioners will sometimes need convincing that they are experts in conveying scientific principles to young children, but stories, such as The Magic Tree, are full of ‘ways in’ to complex learning.
PE needs preparation, planning and purpose
Authors: Andrews Crispin
Published: May 2014

During his six years of involvement in school PE and sport, Crispin Andrews, a primary teacher, qualified sports coach and freelance writer from Aylesbury in Buckinghamshire, has noticed major variations in the degree of organisation and structure, not to mention profile, afforded to this subject.
A week IN THE LIFE OF
Authors: Stowell Pam
Published: May 2014

Lunchtimes, the equation may not look good: six adults, 143 children and one hour 15 minutes ‘free time’. But Pam Stowell, senior midday supervisor at Riddings Infant School, Scunthorpe, has a wonderful ethos which makes for happy and successful dinnertimes.
Uniforms are good if the price is right
Authors: Rhodes Liz
Published: May 2014

Why do schools have uniforms? Liz Rhodes, a primary school teacher from Exeter, Devon, is also consultant editor to Five to Eleven, and looks at this issue.
It's all a question of supply and demand
Authors: Eldridge Fiona
Published: May 2014

Fiona Eldridge is chairman of Teaching Personnel, one of the UK's largest teacher supply agencies. She is committed to ensuring that supply teachers are of a high standard and have access to continuing professional development.
Arthur
Authors: Hart Tara
Published: May 2014

The story structure is fairly repetitive, and is thus a good model both for oral retelling and using as a basis for children's own stories. By Tara Hart, an advanced skills teacher at St John the Divine, Kennington, London.
Jobs crisis won't be solved ‘until we value teachers’
Authors: Nash Sally
Published: May 2014

Could we be heading for a winter of discontent as more and more workers strike over pay? London tube workers and firemen have already taken industrial action and teachers may be next in if their salaries are not upped considerably. Journalist Sally Nash, a former teacher, explores this issue.
Rudyard Kipling is simply Just So!
Authors: Fox Jennifer
Published: May 2014

Kipling's Just So Stories are 100-years-old this year. Jennifer Fox, a special needs teacher working in Macclesfield, Cheshire, shows how they can encourage budding writers to play with language and think about ethics at the same time.
Going back to the drawing board
Authors: Richardson Sarah
Published: May 2014

Ways to evaluate and improve the design process by Sarah Richardson, an art and design consultant from London. For more information call 020 7737 4545 or visit www.arttime.co.uk
A testing time for Twigg as Prince Charles speaks out
Authors: Nash Sally
Published: May 2014

Both Prince Charles and a recent Canadian report independently come to the same conclusion: repeated testing is wrong. Journalist Sally Nash, a former teacher, reports.
Over-exposed! TV can be bad for health
Authors: Rhodes Liz
Published: May 2014

We should be worried about children being exposed to the all-pervasive screen culture. Liz Rhodes, a primary school teacher from Exeter, Devon, and consultant editor to Five to Eleven tells us why.
Foundations of literacy
Authors: Palmer Sue
Published: May 2014

Prepare for formal teaching with a rigorous programme of learning skills and concepts essential to children's development in literacy
Advisor's view
Authors: Cowan Georgie
Published: May 2014

Georgie Cowan discusses the importance of teaching personal, social and health education to young children
Water, water, everywhere!
Authors: Hammond Paula
Published: May 2014

In science, ideas that we want to test are called hypotheses. This month, we are going to test three hypotheses about water: ′Water changes state when it warms up or cools down.′ Water "expands" (gets bigger) when it freezes.′ The freezing and boiling points of water are always the same.′
Easy peasy ice lollies
Authors: Hammond Paula
Published: May 2014

Paula Hammond's science activity give children the opportunity to make a range of cooling summer iced deserts
Our world is changing — we need to change too
Authors: Louis Sara
Published: May 2014

This second column on the changing population of the UK looks at the impact of immigration on social values
Becoming an artist
Authors: White Hilary
Published: May 2014

Many famous artists use simple techniques that even the youngest children can explore for themselves. Looking at the work of well-known artists is a great way to introduce your children to art appreciation – and it can give you lots of new ideas to try!
Messages of hope
Authors: Lepkowska Dorothy
Published: May 2014

Dorothy Lepkowska talks to one head teacher about his school′s international links
Looking at turtles
Authors: Ranger Sue , Richardson Peter
Published: May 2014

Children have a natural empathy for small creatures. This lesson teaches them how tiny hatchling marine turtles cope with the most dangerous phase of their lives, how nature has ensured that turtle populations prevail despite natural threats, and why added pressure from human activities threatens their future survival.
Lesson Plans
Authors: Foster Denise , Bower Jane , Freer Fiona
Published: May 2014

It can be helpful to clarify the concepts which we want children to grasp in order to begin instilling a sense of the past. These include: _ People were alive before we were.
Teaching circus skills!
Authors: Youngman Angela
Published: May 2014

Angela Youngman explains why learning clowning, tight-rope walking and juggling are great for children
Are you stuck in a rut?
Authors: Adams Margaret
Published: May 2014

Margaret Adams advises you to check out if you′re a stick in the mud when it comes to your professional development
After-school clubs The funding crisis
Authors: Lepkowska Dorothy
Published: May 2014

Dorothy Lepkowska reviews some of the problems faced by extended schools and talks to two headteachers to find out their take on the subject.
Into Europe: UK-German Connection
Authors: Maiden Andrew
Published: May 2014

During the state visit to Germany by the Queen in 2004, ministers from the two countries launched an initiative aimed at strengthening bilateral youth links. UK-German Connection, which is the result, is dedicated to increasing understanding between young people in the UK and Germany. Email: info@ukgermanconnection.org
Eco-fundraising; Everyone's a winner
Authors: Youngman Angela
Published: May 2014

Angela Youngman profiles three green money spinning ideas.
Fee-charging charities The public benefit requirement
Authors: Gibbs Marion
Published: May 2014

The Charity Commission has indicated that fee-charging schools that are charities should be both offering pupil bursaries and sharing their facilities and resources with state schools. How realistic is this?
Cooking up a storm: MyDish
Authors: Youngman Angela
Published: May 2014

Angela Youngman considers a tastier way to raise funds for your school.
Making a killing: Murder mystery evenings
Authors: Youngman Angela
Published: May 2014

Angela Youngman talks to a school that regularly and successfully holds mystery nights and explains how you could incorporate them into your fundraising calendar.
Promoting PTAs: Join In Day
Authors: Galbraith Jane
Published: May 2014

If your school has a PTA or similar home-school association then make a date to celebrate its achievements, while helping the NCPTA to highlight the value of PTA, on a national scale.
Learning and earning: The yearbook
Authors: Berry Neil
Published: May 2014

It is always pleasing when a fundraising opportunity can be used to enhance the learning experience of students, and the yearbook provides an ideal opportunity to do this, writes Neil Berry.
Working effectively: Skill mix in specialist nursing teams
Authors: Lightfoot Tina
Published: May 2014

This article discusses a project which was undertaken to assess the feasibility of introducing a different skill mix within a specialist nursing team.
Dyspepsia, part 1 − the determinants of health, are they social or political?
Authors: Griffiths Helen
Published: May 2014

This two−part article looks at how current health care policies, both general and those affecting patients with dyspepsia, specifically shape what and how services are delivered into the future. What will influence the patients′ response to these changes in service delivery given the concept of consumerism and how do healthcare professionals engage patients within this concept to make choices regarding their health? The purpose is not to provide all the answers, but challenge healthcare professionals to seek a balanced redress of the burden of dyspepsia on the patient, the NHS and society as a whole.
National audit of stoma complications within 3 weeks of surgery
Authors: Cottam Jude , Richards Karen
Published: May 2014

The objectives of this audit were to:

1. Identify the incidence of problematic stomas within the UK;

2. Highlight any dissimilarity of incidence from centre to centre;

3. Confirm the height of the stoma as being a predisposing factor to complications;

4. Initiate research.

Of the 256 hospital−based stoma care services within the UK, 93 registered for the audit, the final total being 3970 stomas with 1329 (34%) meeting the criteria of problematic, with a variance from centre to centre of 6−96%. The loop ileostomy was reported as the most problematic with a height of less than 20mm at time of fashioning. Problems are more likely to occur after emergency surgery. The major problem is retraction, accounting for 40% of the total problems. Men have more stomas raised than women yet report fewer complications. This audit provides some predisposing factors to problematic stomas: height of stoma, stoma type, patient gender and body mass index, and underlying disease.
New treatment options for patients with faecal incontinence
Authors: Murphy Jamie , Lawes Daniel , Vasudevan Subash , Scott Mark , Lunniss Peter
Published: May 2014

Acquired faecal incontinence (FI) is common, underappreciated and socially devastating. Obstetric trauma and anal surgery are major risk factors for FI. The true incidence is unknown, but FI is seen in 2% of the adult population increasing to 14% in those over the age of 65 (Nelson, 2004). This can affect very young patients with anorectal injury, a group which is easily identified. However, occult injuries also occur. In those who have delayed presentation after the injury, symptoms generally occur in the sixth decade. This is presumably due to ′multiple hits′, where aging, the menopause and pelvic denervation exacerbate occult obstetric or iatrogenic sphincter dysfunction. Treatment is a major challenge for both medical staff and clinical nurse specialists alike, but simple measures can greatly improve quality of life. For patients who fail maximum conservative treatment, significant advances in surgical procedures have occurred in the past decade. This review focuses on advances in the understanding and treatment of faecal incontinence. While this is not a systematic review, we have evaluated the treatments which are currently available in tertiary gastroenterology centres, supplemented by a Medline search using the keywords ′faecal incontinence′. In conclusion, we suggest a simple algorithm to aid management of this difficult condition.
A clinical audit of the ileo−anal pouch service at St Mark's Hospital
Authors: Perry−Woodford Zarah
Published: May 2014

Improving the quality of health care requires a range of evidence−based activities, such as clinical audit and feedback (Foy et al, 2005). This incorporates the foundations of clinical governance in supporting staff to deliver safe care of the highest quality. Agencies such as the National Institute for Health and Clinical Excellence (NICE) advance and encourage audit and feedback in order to set guidelines for future practice and development of specific services. Clinical audit was introduced in the NHS in 1993 and is defined as ′a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change′ (NICE/CHI, 2002). This article outlines an audit to provide feedback on the current pouch care service, and to revise practice in line with a changing NHS.
Improving stoma surgery outcomes:more patient choice, more psychosocial support
Authors: Simmons Kingsley L
Published: May 2014

There can be very little doubt that the quality of care stoma patients receive has improved over the years. This coincides with significant advances in stoma appliance technology and an increase in the number of specialist nurses. However, a lot of patients remain emotionally disturbed and express problems with social and sexual relationships long after the formation of their stoma. Patients experiencing these difficulties stay largely undetected, receiving very little, or no, professional support. An examination of the literature suggests that more patients would benefit if stoma therapists were trained to address uncomplicated social and psychological concerns, if patients were monitored for a longer period of time and if they were offered a choice of stoma appliances.
The National Nurse Endoscopist Project
Authors: Johnston Debbie
Published: May 2014

Nurse endoscopists have long been an integral part of providing endoscopy services. In this article, Debbie Johnston discusses the work of the National Endoscopy Training Programme to assess the needs of nurse endoscopists in the UK, and presents some of the results of a national questionnaire, launched as part of this unique, collaborative project.
A guide to caring for patients with a newly formed stoma in the acute hospital setting
Authors: Fulham Juliette
Published: May 2014

This article outlines the fundamental aspects of stoma care required by individuals undergoing surgery requiring stoma formation. For health care professionals who may be unfamiliar with the basic principles of stoma care and who are involved in the care of this group of patients, it aims to provide an overview of post−operative stoma care, emotional support for the patient and ongoing support after discharge. The importance of selecting the correct appliance, the role of the stoma care nurse specialist and common stoma complications are also addressed.
Help−seeking process in women with irritable bowel syndrome. Part 1: study results
Authors: Bourgault Patricia , Devroede Ghislain , St−Cyr−Tribble Denise , Marchand Serge , Barcellos de Souza Juliana
Published: May 2014

This study explores the entire help−seeking process in women with irritable bowel syndrome (IBS). A mixed−method design was chosen for this study. The qualitative part (grounded theory) supports the help-seeking process′s theorization and the quantitative part describes two possible predictors (abdominal pain and psychological distress). Nineteen IBS women (confirmed by Rome II criteria) were included in the study. Interviews and testing (pain and distress) were done. The emerging model includes three categories: health problem; personal characteristics; and help-seeking process. These categories allow an understanding of the help−seeking process and the role of distress. Part 2 of this article will be discussing the results of this study.
Comparing experiences of the enhanced recovery programme: UK and Sweden
Authors: Burch Jennie
Published: May 2014

The enhanced recovery programme is performed in an increasing number of UK hospitals and can reduce hospital stays to around 4 days. Early feeding, early mobilization and provision of preoperative information are included in enhanced recovery. In this article, Jennie Burch discusses the principles of enhanced recovery and describes a trip to Sweden to observe another enhanced recovery centre. While there are similarities between the author′s centre and the Swedish centre, there are still opportunities to learn and share experiences. Enhanced recovery can only succeed if the multidisciplinary team collaborate and work together.
Legitimizing patient sexuality and sexual health to provide holistic care
Authors: Odey Kathryn
Published: May 2014

Sexuality and sexual health discussion often remain taboo within nursing practice, despite being recognized as an integral part of the ′whole person′. Kathryn Odey outlines some of the possible reasons why health professionals find it so difficult to address this topic. The importance of introducing sexuality to legitimize it as a normal aspect of holistic health care will be discussed. Nurses should be aware of the impact of their own beliefs and attitudes on the way they approach matters of sexuality and sexual health, particularly as patients expect health professionals to identify and initiate such discussions.
Innovation in GI nursing
Authors: Harrison Penny
Published: May 2014

Penny Harrison, senior lecturer in adult nursing, De Montfort University, Leicester, discusses the importance of innovation. Nurses are well placed to propose practical solutions to everyday problems, and even small changes can have a significant impact and value in improving patient care.
Journal Scan
Authors: Coutts Alison
Published: May 2014

Interleukin 17 (IL17) is known to be involved in a variety of chronic inflammatory diseases; some studies suggest that it is raised in both Crohn′s disease and ulcerative colitis, while other studies suggest that it is raised in one but not the other. Interferon gamma (IFN?) is a product of a type of T helper cell which is raised in IBD but, again, the clinical significance of this is not known. This study took endoscopic samples from patients with both types of IBD, and also controls (who were being investigated or treated for diarrhoea or cancer—the ethics of this was not discussed). The levels of IL17 and IFN? were compared to the clinically assessed disease severity.
Peristeen rectal irrigation for functional bowel disorders: Which patients benefit?
Authors: Whitehouse Pauline A , McWilliams Dawn , Katt Carol , Bearn Philip E
Published: May 2014

Functional bowel disorders (FBD) are distressing for patients and pose a treatment dilemma for clinicians. Management is usually conservative, with rectal irrigation one of the available treatments. This study aimed to determine the acceptability and efficacy of rectal irrigation in a group of patients with FBD who had not responded to standard biofeedback treatment. All patients had previously been appropriately investigated and undergone standard biofeedback treatment with psychological assessment. Patients were taught to irrigate by a specialist nurse and followed up regularly. A visual analogue score was used to quantify symptoms. Over an 8-year period 113 patients were treated with rectal irrigation.
Goal setting for faecal incontinence: A patient-centred approach
Authors: Aston Becky , Sheehan Liz
Published: May 2014

Faecal incontinence has a direct impact on quality of life yet outcome measures often omit the patient′s personal experiences and hopes and goals in treatment. By involving patients in the goal setting process, health professionals can gain an improved understanding of the impact of symptoms, while patients are motivated to follow treatment programmes. Becky Aston and Liz Sheehan outline the rationale behind a patient-centred approach to goal setting and suggest practical ways in which health professionals can work with patients in this important aspect of treatment and rehabilitation.
The role of an integrated care pathway in a nurse-led dyspepsia clinic
Authors: Wong Mandy
Published: May 2014

The National Institute for Health and Clinical Excellence (NICE) (2004) has identified that dyspepsia management can be standardized, structured and categorized, which means that an integrated care pathway (ICP) can be developed and implemented in local hospitals. Mandy Wong outlines how an ICP can be used in a nurse-led dyspepsia clinic to provide patients with sufficient contact time while allowing nurse specialists to advise on drug use, diet and lifestyle and identify alarming symptoms that require fast-track investigations.
The bowel cancer screening programme: Understanding the rationale
Authors: Coutts Alison
Published: May 2014

The National Bowel Cancer Screening Programme is currently being rolled out across the UK. With 100 people diagnosed with bowel cancer every day (Cancer Research UK, 2009), the screening programme aims to recognize bowel cancer in its early stage in as many people as possible. While there is agreement as to the age group to be screened, pilot studies have shown that the target population has demonstrated some reluctance to undergo testing due to the methods of collecting samples. With April being bowel cancer awareness month, Alison Coutts argues that nurses need to reassure and encourage eligible participants.
Ensuring effective technique in colostomy irrigation to improve quality of life
Authors: Perston Yvette
Published: May 2014

The formation of a stoma causes physical changes to a patient's body that can cause alterations in his/her body image (Vujnovich, 2008). It is vital to an ostomist's wellbeing that he/she achieves a self-care management regimen which is suitable to his/her lifestyle. Colostomy irrigation is a safe and effective means of enabling colostomists to regain their bowel control, which has a significant impact on self-esteem and quality of life. Yvette Perston explains how colostomy irrigation works, who can use it, and the proper technique to ensure patient safety and minimal discomfort. By understanding the rationale behind the technique, health professionals can better assist patients in successful emptying of the bowel.
Complications arising from poor stoma siting
Authors: Rust Julie Anne
Published: May 2014

It is important to correctly position a stoma because a poorly sited stoma can result in management and psychological problems for the patient and increase the potential for pouch leakage. However, a well sited stoma can improve the quality of life for a patient and can therefore help the individual to accept the stoma. In this article, Julie Rust discusses the complications that arise from poorly sited stomas.
Dynamic nursing in endoscopy
Authors: Longcroft-Wheaton Gaius , Bhandari Pradeep
Published: May 2014

The advancements in endoscopy has meant that the role of endoscopy nurses has also changed. Endoscopic practice is underpinned by a team approach and endoscopic nurses play a critical role within the team. In this article, Gaius Longcroft-Wheaton and Pradeep Bhandari, |discuss the concept of dynamic nursing and the ways in which a team approach can improve patient care and outcome.
The industries role in supporting the education of nursing
Authors: Foskett Kathryn
Published: May 2014

With an ever increasing pressure on the NHS to cut costs while still maintaining a high standard of patient care, it would appear that many nurses are struggling to access the educational resources needed to provide continued professional development. A shift appears to be developing in how traditional educational programmes are taught and accessed. The clinical nurse specialist now plays a more pivotal role in the continued professional development of those around them through a number of different educational initiatives, often in collaboration with commercial companies. In this article, Kathryn Foskett addresses the role that industry plays in supporting clinical nurse specialists help educate their nursing staff.
Recognizing the depth of the IBD nurse specialist role
Authors: Hall Alex
Published: May 2014

In this climate of austerity, the question has been raised regarding the benefits and functions of nurse specialists. In this article, Alex Hall discusses demonstrating the complexity of the role of the inflammatory bowel disease (IBD) specialist nurse and cost benefits to managers and commissioners. It also aims to examine the importance different methods of collecting both qualitative and quantitative data to demonstrate the depth and complexity of the role.
Closing the audit loop—stoma complications within 3 weeks of surgery
Authors: Cottam Jude , Richards Karen
Published: May 2014

Following the 2005 nationwide prospective audit of stoma complications (which identified 34% of stomas as problematic), Jude Cottam and Karen Richards set out to identify the incidence of stoma complications in the UK, to highlight any dissimilarity from centre to centre and to ascertain if the height of the stoma is a predisposing factor. The audit was commenced in February 2010 and completed in January 2011. Unfortunately, the data are not comparable to the 2005 audit due the lack of centres participating (96 in 2005 vs 44 in 2010) and numbers of stomas (3970 in 2005 vs 1197 in 2010).
Short bowel syndrome: the pathophysiology and treatment
Authors: Peck Jacquie , Soo Lian , Boland Lela , Windsor Al , Engledow, Consultant Surgeon Alec
Published: May 2014

Short bowel syndrome is a complex part of intestinal failure. This group of patients have complex care pathways requiring the management from a specialist multidisciplinary team. Nutrition, fuid and electrolyte management, complex wound management, surgical interventions and psychosocial support are part of the daily treatment. If managed incorrectly, short bowel syndrome can be life threatening. In this article, Jacquie Peck, Lian Soo, Lela Boland, Al Windsor and Alec Engledow provide an explanation of the pathophysiology of short bowel syndrome and management provided by a specialist unit.
Patients' need for nursing telephone follow-up after enhanced recovery
Authors: Burch Jennie , Taylor Claire
Published: May 2014

The care of patients undergoing colorectal surgery in UK hospitals is increasingly being guided by an evidence-based care pathway known as Enhanced Recovery After Surgery (ERAS). However, it is not known how well patients recover in the period between discharge home from hospital and surgical follow-up in the outpatient clinic. In this article, Jennie Burch and Claire Taylor identify patients' concerns at this time and discuss their support needs following participation in the ERAS programme. Data collected from nurse-led follow-up telephone calls are presented to give insight into the nature of nursing follow-up required. The main concerns identified during the telephone calls were: dietary intake, excessive tiredness and bowel function, which could be problematic for several weeks following discharge. In approximately half of the cases, there was need of nursing support during the first month at home. These findings have led to greater awareness of patients' concerns following hospital discharge from the ERAS programme. Subsequent service improvements have been made to better meet patients' needs.
Holistic needs assessment following colorectal cancer treatment
Authors: Taylor Claire , Cummings Roni , McGilly Claire
Published: May 2014

A diagnosis of colorectal cancer and its subsequent treatment can adversely affect survivors’ quality of life ( Denlinger and Barsevick, 2009 ). Following treatment, cancer survivors may have a range of physical, emotional and spiritual needs—given the growing recognition of these negative sequelae, we must consider how best to ameliorate these and enhance the quality of colorectal cancer survivorship. Undertaking an effective holistic needs assessment (HNA) is one way to ensure that patients’ needs are fully identifed (National Cancer Action Team, 2012). The National Cancer Survivorship Initiative (NCSI, 2012) advocates that HNA should be an essential component of cancer survivors’ care throughout their pathway; it may lead to earlier interventions and diagnosis of consequences of treatment, improved communication and better quality of care. While most cancer nurses would endorse this, the implementation of holistic needs assessment (HNA) into usual after-care support can prove challenging. In this article, Claire Taylor, Roni Cummings and Claire McGilly discuss how one service set out to achieve this, and present some early patient feedback to indicate the merits of doing so.
Nursing interventions to improve bowel function after rectal cancer treatment
Authors: Taylor Claire , Bradshaw Ellie , Walker Julie , Wood Tracy
Published: May 2014

At least half the number of patients treated for rectal cancer will experience a bothersome change in their bowel function ( Peeters et al, 2005 ). Symptoms include frequency, urgency, fragmentation of stools and possible incontinence, which often occur in combination. Many who suffer from such symptoms are unaware that altered bowel function is a common consequence of rectal cancer treatment and that a range of helpful interventions exist ( Nikoletti et al, 2008 ). In this paper, Claire Taylor, Ellie Bradshaw, Julie Walker and Tracy Wood examine how, in addition to preparing patients for what to expect after treatment, nurses can lead in both assessing and addressing any changes in bowel function. Intervening early during follow-up can ameliorate much distress and minimise the extent to which bowel function affects individual quality of life (Taylor, 2011).
Indigo carmine or Lugol's iodine? A beginner's guide to chromoendoscopy and advanced imaging
Authors: Basford Peter John , Benton Anna , Jarvis Tracie , Bhandari Pradeep
Published: May 2014

In recent years in the UK, there has been a rapid growth in the use of dye-based and image-enhancement techniques during endoscopy. Chromoendoscopy dyes include indigo carmine, methylene blue, Lugol's iodine and acetic acid, while advanced-imaging technologies include narrow-band imaging, flexible spectral imaging colour enhancement, i-Scan and autofluorescence imaging. The primary aim of chromoendoscopy and advanced imaging is to improve detection and characterisation of lesions during gastrointestinal endoscopy. In this paper, Peter Basford, Anna Benton, Tracie Jarvis and Pradeep Bhandari give an overview of the more commonly used techniques in endoscopy, together with the indications and evidence for their use.
Dispelling dietary myths of liver disease
Authors: Leaper Julie , Hamlin Susie
Published: May 2014

Nutrition in patients with liver disease has changed beyond recognition in the past 20 years. Historically, low-fat and low-protein diets were advised, but these have now been proven unnecessary and can lead to malnutrition ( Plauth et al, 2006 ). Today, emphasis is placed on treating malnutrition and feeding to elevated nutritional requirements, and there are very few dietary restrictions necessary. Therapeutic dietary intervention is still appropriate for symptoms such as ascites, jaundice, and diabetes. Information available through the internet and media can often be conflicting and confusing, so advice should be sought from a registered dietitian, nurse, or GP with relevant experience. This article aims to dispel some of the commonly held myths about nutrition in liver disease.
Motivational interviewing to improve inflammatory bowel disease outcomes
Authors: Ramdeen Madhoor , Poullis Andrew , Gupta Sachin , Ghosh Deb
Published: May 2014

As practitioners working with patients with inflammatory bowel disease, it is important that we have a fundamental understanding of the risk factors associated with nonadherence. Only in doing so will we be able to design an efficacious theory-based intervention to ameliorate nonadherence. However, the question remains as to what to do in the mean time as practitioners to assist our patients in becoming more collaborative and adherent. Motivational interviewing (MI) was first introduced nearly 30 years ago and continues to attract attention among clinicians and researchers. We know very little about the mechanisms for change and how MI can be adapted to these mechanisms, but MI is more than just a behavioural strategy to elicit and reinforce change talk. It is about helping patients lead satisfying lives and choosing activities to help them foster their goals. Although MI might seem like a time-consuming process, it can prove useful in eliciting how we can best help our patients to bring about the change they need.
Getting nosey about IBD
Authors: Stansfield Catherine
Published: May 2014

Catherine Stansfield, Advanced Practitioner in Gastroenterology, Salford Royal Hospitals NHS Trust, Salford, discusses the use of simple noninvasive tests, like the gas chromatograph, for early IBD detection
Imaging of the jaundiced patient
Authors: O'Regan Declan , Tait Paul
Published: May 2014

Jaundice is a common condition which has a wide range of causes. Imaging plays a vital role in establishing the underlying aetiology and planning management. Image-guided interventional techniques are used for therapeutic procedures and for diagnostic purposes.
The genetics of hearing loss
Authors: Aggarwal R , Saeed SR
Published: May 2014

Hearing impairment is the most common sensory deficit with half of the causes of hearing loss having a genetic basis. There is a range of treatment devices but these do not correct the underlying pathology. Advances in molecular biology have greatly enhanced our understanding of the pathophysiology of genetic hearing loss, including potential treatments.
Hepatitis C: tackling the silent epidemic
Authors: Hamlyn Adrian N
Published: May 2014

Chronic hepatitis C virus infection is responsible for a significant and growing burden on NHS services. It is one of the commonest causes of liver cirrhosis and hepatocellular carcinoma, and the leading indication for liver transplantation. Major advances have been made in treatment, which can eradicate the virus in more than 50% of patients and reduce complications, but progress is hampered by inadequate detection and access to treatment.
Benefits of interprofessional learning: an interprofessional MSc in child health
Authors: Payne Heather , Pelz Frauke , Brooks Rachel , Horrocks Lyn , Kemp Alison , Webb Elspeth , Street Eddy , Sibert Jo
Published: May 2014

This article addresses interprofessional education (IPE) using a case study evaluating a multidisciplinary MSc course in child health. The participants felt that the nature of the course increased their interprofessional working skills and professional confidence. They described benefits, including new insights, a balanced variety of views, development of respect and equality between professionals, improved communication and a holistic approach to child health.
Life after Vioxx: the clinical implications
Authors: Fortum PJ , Hawkey CJ
Published: May 2014

The withdrawal of Vioxx, as a result of concerns regarding cardiovascular risk, has left unanswered questions about the safety of COX-2 inhibitors and nonsteroidal anti-inflammatory drugs (NSAIDs) in general. However, to what extent should the concerns about Vioxx be extended to other anti-inflammatory drugs?
Injuries to the lumbar spine: identification and management
Authors: Woolard Alexander , Oussedik Sam
Published: May 2014

Fifteen percent of spinal injuries occur in the lumbosacral region. Damage to the spinal cord or cauda equina is a possible complication. Thorough assessment of all trauma patients for such injuries will result in early diagnosis and optimal outcome can be achieved. This article looks at the identification and management of injuries to the lumbar spine.
Time to hand over our old way of working?
Authors: Harrison Mark , Eardley William , McCarron Brendan
Published: May 2014

The European Working Time Directive and the change to shift working have highlighted the need for a high level of continuity of patient care. Continuity of information, through a competent and professional handover allows doctors to be not only made aware of the issues important to each patient's care, but also allows a knowledge-based approach to that patient's management.
Recurrent hyperparathyroidism caused by parathyromatosis
Authors: Evans CFM , Mansfield L , Sharma AK
Published: May 2014

In 1987, an Indian lady, aged 62 years, first presented complaining of a 1 year history of weight loss, poluria, polydipsia and lethargy. On examination of the neck there was a palpable nodule arising from the lower aspect of the right thyroid lobe. Bloods revealed raised corrected calcium of 3.62 mmol/L (normal 2.18–2.47 mmol/L). Neck ultrasound scan showed a large nodule in the right lower lobe of the thyroid, thought unlikely to originate from the parathyroid glands due to its size.

After failed conservative treatment the patient underwent cervical exploration. A bilobed nodule was removed from the right side with a total weight of 12.5 g. Two specimens were sent for frozen section and histology confirmed the diagnosis of a parathyroid adenoma (weights 0.91 g and 11.60 g respectively). The larger specimen was documented as partially encapsulated, cystic and degenerative. Post operatively normocalcaemia was achieved with resolution of preoperative symptoms.

Fourteen years later, in 2001, the lady presented with low back pain. She was found to have hypercalcaemia (adjusted calcium of 2.93 mmol/L) and hyperparathyroidism (parathyroid hormone level 46.7 pmol/L, normal values 1.1–6.9 pmol/L). Initial investigations, including a neck ultrasound scan, sestamibi scan, magnetic resonance imaging (MRI) scan of the neck and chest and parathyroid venous sampling were unable to localize the source of the hyperparathyroidism. In 2003, as a result of increasingly problematic symptoms, further localisation studies were performed. Ultrasound showed an enlarged parathyroid gland inferior to the right lobe of the thyroid. The decision was then made to proceed to re-exploration of the right side of the neck.

At the repeat exploration, aided by methylene blue localization, multiple nodules of parathyroid tissue were identified in the following areas: subcutaneous tissue (within the midline); superficial and lateral to left sternocleidomastoid muscle; Adherent to the right recurrent laryngeal nerve; within the left sternothyroid muscle; right paratracheal and paraoesophageal areas; bilaterally in the thymus glands.

All macroscopic nodules were excised and bilateral cervical thymectomies performed with no visible residual disease remaining. Histology confirmed multiple well-circumscribed nodules of parathyroid tissue similar to that originally excised and a diagnosis of parathyromatosis was recorded. The patient's subsequent calcium levels have fallen, her symptoms have improved and she is currently well.
Alcohol dependence and treatment strategies
Authors: Ibrahim Furhana , Gilvarry Eilish
Published: May 2014

Alcohol misuse and dependence is a major health and social issue worldwide. This review addresses alcohol dependence, the current approaches to treatment and some methods for trying to prevent relapses.
The electrocardiogram in pulmonary hypertension
Authors: Lewis Clive , Lambiase Pier
Published: May 2014

Figure 1 shows the electrocardiogram of a 60-year-old woman who initially presented in the third decade of life with mild symptoms of dyspnoea, reduced exercise capacity and fatigue. Clinical signs included cyanosis and clubbing, right ventricular heave, palpable and loud pulmonary second sound, and a soft pansystolic murmur. Echocardiography confirmed a patent ductus arteriosus and evidence of pulmonary hypertension with right ventricular hypertrophy (RVH), significant tricuspid regurgitation and pulmonary regurgitation.