bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole-brain learning
Authors: Doyle Phoebe
Published: May 2014

Acknowledging differences between the genders regarding development and specific learning styles can serve to promote equality in the early years by enabling all children to achieve their potential.
Inside the magic box
Authors: Leeper Marion
Published: May 2014

Young children will sometimes show a strong interest in enveloping and enclosing, which can be hard for practitioners to accommodate. As usual, traditional stories, are perfect for exploring such schemas.
There is no need for small print
Authors: Tanuku Purnima
Published: May 2014

Purnima Tanuku explains the vital importance of clear parental contracts and outlines your role in ensuring that parents are fully aware of key terms and conditions, including all fees and charges.
Independent interaction
Authors: Jarmola Daniel
Published: May 2014

Daniel Jarmola shares his experiences of using interactive computer technologies, such as whiteboards and the SMART Table™, to explore independent learning with young children in a school reception class.
The things we find in dens
Authors: Barber Jenny
Published: May 2014

Children love finding somewhere to hide outdoors, whether they are camping out, studying the natural world or as part of their everyday role-play experience; as practitioners we can tap into this enthusiasm.
Making learning visible
Authors: Kiely Teresa
Published: May 2014

The Reggio Emilia approach to early years education is rightly held up as an example of best practice throughout the world, but how does our very own Early Years Foundation Stage fare in comparison?
Review shackled by education system
Authors: Henty Neil
Published: May 2014

CHILDREN'S MINISTER, Sarah Teather MP, has announced the planned review of the Early Years Foundation Stage (EYFS) is to go ahead, chaired by Dame Clare Tickell, chief executive of Action for Children. It will deliver its fi nal report in spring 2011, followed by a consultation period, before proposed changes are implemented in September 2012. So, any changes you might like to take place concerning the EYFS, will have to wait for a further two years.
Getting into the great outdoors
Authors: Bayram Liz
Published: May 2014

Despite working in a diverse range of settings childminders have a duty to offer the children in their care a wide range of outdoor activities, which can obviously provide quite a challenge for some.
Making the time to talk
Authors: Hayes Anne
Published: May 2014

Anne Hayes describes the experiences of one nursery in London who participated fully in the Every Child a Talker programme, and how the provision and outcomes for children changed as a result.
Managing chickenpox
Authors: Stevenson Jane
Published: May 2014

Most practitioners will encounter an outbreak of chickenpox during their career, possibly many, which makes it worth knowing some simple facts about the disease, how it spreads and how to contain it.
Widening participation
Authors: Dallal Jo
Published: May 2014

Students attending Foundation Degrees can often fall in the 20 to 60-year-old age range, and while this is commendable, we must be aware that they may need extra support for difficult challenges they face.
Creating life from clay
Authors: Leeper Marion
Published: May 2014

Father Snake, Mother Bird is based on a traditional creation myth from Vietnam, but just as importantly, it also provides the perfect opportunity to let children experience the magical modelling qualities of clay.
Upstairs and downstairs
Authors: Harries Judith
Published: May 2014

Two well-known rhymes, which are linked through their use of alliteration and a focus on movement. This article explores each of the Early learning Goals with a special emphasis on physical development.
Provocative in Reggio
Authors: Moss Peter
Published: May 2014

The pre-schools of Reggio Emilia have become a place of pilgrimage for early years practitioners from around the world, and although not transferable in full, its practice offers us many important lessons.
Playful learning with ICT
Authors: Siraj-Blatchford John
Published: May 2014

Some of the criticism levelled at passive television viewing has unjustly been applied to all screen-based ICT, yet quality educational software will adhere to evidence-based principles of good practice.
Play memories revived
Authors: Sharpe Deborah
Published: May 2014

When we observe and try to understand how the children in our care play it is good practice to reflect on our own childhoods and to remember the many games and activities that used to occupy our time.
Leading with integrity
Authors: Jefferies Tina
Published: May 2014

We often hear people talk about integrity, normally when someone is considered not to have that particular quality, but what exactly is it, and just how important is it for respected leaders to posess?
The physicality of art
Authors: White Hilary
Published: May 2014

Although we are comfortable with the concept of cross-curricular activities we still tend to view artistic pursuits as having creative goals only, overlooking their undoubted potential for physical development.
The sunny days of June
Authors: Bromley Helen
Published: May 2014

This 12-part series offers a month-by-month guide for practitioners working outdoors with young children, that will support them and help you celebrate, whatever the weather – this month, June.
Powerful teamworking
Authors: Jefferies Tina
Published: May 2014

Every successful organisation relies on its mix of people and their skills, personalities, professionalism, and dynamism, and all of these traits stem from your leadership style and how you integrate your team.
Strong hands and fingers
Authors: Day Lin
Published: May 2014

If the senses are fully functional, and plenty of opportunities to manipulate weighted, shaped and tactile objects have been provided, hand development will follow a set sequence in young children.
How music helps children learn and develop across the curriculum
Authors: Carling Sarah
Published: May 2014

Music is important for all sorts of reasons, however, ensuring that it is of the highest quality is not always as easy as it might seem. Sarah Carling offers practical advice on how to offer stimulating opportunities.
Healthy and confident children
Authors: Simpson Maggie
Published: May 2014

The Play, Talk, Read programme, that has successfully encouraged thousands of parents to do just that more often with their children, will be rolled out throughout Scotland over the coming year.
Diwali
Authors: Chapman Ailsa
Published: May 2014

In this month's article we explore Diwali, also known as the ‘Festival of Lights’, which is celebrated by people of the Hindu, Jain and Sikh religions across the world, for differing reasons.
Beautiful bundles of joy
Authors: Sharpe Deborah
Published: May 2014

Babies come in all shapes and sizes, and whether they be human, animal, insect or otherwise, every living thing must be born. Birth fascinates young children and offers many learning opportunities.
The language of paint
Authors: Soar Sussan
Published: May 2014

Your local gallery or museum may house rich starting points for your next topic. This article explores the National Gallery's ‘Take One Picture’ approach and how it can be applied to using art in your setting.
Mathematics in bloom
Authors: Moffett Pamela
Published: May 2014

Dr Pamela Moffett observes a nursery class as they develop problem solving skills during a daffodil bulb planting activity and asks what children learn, and how, by exploiting mathematics in real-life contexts.
Volunteering and awareness
Authors: Shukla Anand
Published: May 2014

Whenever parents, grandparents or carers offer their time and help within a setting, everybody wins, however, there are still too many people who are not comfortable or confident enough to volunteer.
Our values system is all wrong
Authors: Ellyatt Wendy
Published: May 2014

A recent report from UNICEF, which looked in-depth at the particular pressures faced by UK parents and children, found that it was adults who felt unable to resist the materialism of modern childhood.
What we can learn from…Children's interests
Authors: Allingham Sue
Published: May 2014

It seems fairly obvious to state that we can learn from children's interests but, actually, is this something that gets all too easily missed while ensuring that we are meeting development needs?
From dusk until dawn
Authors: Sharpe Deborah
Published: May 2014

One of our responsibilities when working with children is to help them understand the world in which they live. Fear of the dark is common, but we can help overcome this through fun learning activities.
More talk about books
Authors: Stevens Judith
Published: May 2014

Following on from last month's article that explored the many positive reasons for engaging in dialogic book talk with young children, Judith Stevens delves deeper using a classic tale as a real-world example.
Reclaiming identities
Authors: Mathivet Stephanie
Published: May 2014

Stephanie Mathivet discusses the relational pedagogy that underpins the Pre-school Learning Alliance's early years work, that is helping it gain recognition from the sector for its unique pedagogical identity.
Parents and projects
Authors: Cooper Gillian
Published: May 2014

A project based on Chinese New Year led to one mother becoming involved at the nursery attended by her daughter, which used Scotland's Curriculum for Excellence to fully engage parents as partners.
Rolling and stretching
Authors: Brown Paula
Published: May 2014

Although the benefits of using yoga is well known, for both adults and children, many practitioners still find it hard to incorporate it into their sessions, however, it is much easier than you might think.
Risk is in the eye of the beholder
Authors: Ralph Amanda
Published: May 2014

MA Education Ltd, St Jude's Church, Dulwich Road, London, SE24 0PB. neil.henty@markallengroup.com
Making sense of reading using the context approach
Authors: Wyse Dominic , Parker Christine
Published: May 2014

This article proposes a novel approach to the teaching of language and literacy – its focus is on exemplary practice, built on rigorous theory and evidence, making use of contextualised learning.
Still looking for effective inspections
Authors: Tanuku Purnima
Published: May 2014

Ofsted's decision to reverse a proposal to give schools no-notice inspections, along the lines of private nurseries, means that such settings will remain at a significant disadvantage with the rest of the sector.
What we can learn from… America
Authors: Chapman Ailsa
Published: May 2014

This is the fourth article in a series looking at different countries that will use their characteristics, identity and peoples as starting points for practical activities and learning – this month, USA.
A place for extending talk
Authors: Finlayson Keri
Published: May 2014

Finding the time and space for quiet and focused talk in a setting, for children beginning to understand how to hold a conversation, can prove tricky, but it is very important to provide places for this to happen.
The lost art of caring
Authors: Jefferies Tina
Published: May 2014

Who really cares about care these days, in our achievement-driven, status-orientated, education-focused under-fives provision? Has educating become our only true focus in early years provision?
The Impact of Leaders
Authors: Kemp Nicola
Published: May 2014

One of the criteria for the New Leaders in Early Years course is that students must complete at least one placement in a setting in an area of economic disadvantage, which can have an impact on all involved.
Challenging the status quo: Men in childcare
Authors: Jones Charlotte
Published: May 2014

There are still issues surrounding how we can increase the number of men working in childcare, despite the growing prominence given to the role of fathers in the upbringing of their children.
Beware childcare on the cheap
Authors: Leitch Neil
Published: May 2014

The call for a commission aimed at reducing bureaucracy and reducing costs to parents, seems at odds with the Nutbrown review, released at the same time; there are still many issues to resolve in the sector.
What we can learn from… China
Authors: Chapman Ailsa
Published: May 2014

We continue our series that uses practical activities to introduce young children to the countries of the world, by taking a look at China, with its rich culture and history, and its impact on our lives.
Comment tu t'appelles
Authors: Rivolta Heidi
Published: May 2014

The early years are often seen as the best age to start learning second languages, and what better way to teach basic introductions in French, than to use a puppet that combines fun and learning.
The importance of engagement
Authors: Robb Sue
Published: May 2014

The changes that have affected the early years over the past few years have meant good lines of communication and partnership working between government and the sector have been vital.
Vive la rvolution
Authors: Moore Gill
Published: May 2014

Change is afoot as teachers welcome the prospect of an improved work/life balance, but who will do the tasks that they abandon?
Confident for the classroom
Authors: Andrews Crispin
Published: May 2014

Does initial teacher training unlock the confidence and mindset that will enable a trainee to take responsibility for a class of children? Crispin Andrews spoke to teachers at the beginning of their careers to find out
Literacy theme RHYME
Authors: Palmer Sue
Published: May 2014

Why is rhyme and repetition so important at key stage 1? Literacy specialist Sue Palmer explains the value of those tried-and-trusted, well-known verses
Turn your group work into great work
Authors: Thornton Stephanie
Published: May 2014

Working together, learning together - group work is a key feature of every classroom. But how can you ensure that it is effective?
Absolute beginners: first days at college
Authors: Andrews Crispin
Published: May 2014

So you've made the move into teaching and your training has begun. You might feel unsure but fear not - you're already carrying the skills that will see you through. Crispin Andrews talked to lecturers at a Northamptonshire training college
Literacy theme INSTRUCTION TEXTS
Authors: Merttens Ruth
Published: May 2014

Early years specialist Ruth Merttens explains how you can add sparkle to the teaching of instruction texts
Some optical illusions!
Authors: Hammond's Paula
Published: May 2014

As autumn is for trick or treating, spooky tales and not quite being able to believe what you see, Paula Hammond's activities introduce children to optical illusions
Child safety week
Authors: Hammond Paula
Published: May 2014

Every year, around 100,000 children are seriously injured in accidents. A further 300 are killed. This month's assembly acknowledges these shocking statistics
Where are you from?
Authors: Taylor Di
Published: May 2014

A Third Culture Kid (aka Global Nomads) came about as a title because they represent this extra culture, where they grow up away from �home� or �among worlds�
Heads you win-heads you lose?
Authors: Rhodes Liz
Published: May 2014

Liz Rhodes discusses the benefits of schools employing business managers
The world is their oyster!
Authors: Youngman Angela
Published: May 2014

Linda Marsden talks to Angela Youngman about international links
Being fit and healthy
Authors: Hoad Elizabeth
Published: May 2014

This unit of work will focus on the children writing non−chronological reports based on the topic of healthy eating and maintaining a healthy lifestyle.
Lease finance The business alternative
Authors: Jones Mark
Published: May 2014

Most schools are familiar with the use of lease finance for ICT equipment, but many have yet to investigate it as a means of optimising mid−term budgets. Mark Jones explains how this can work.
Art beat Creativity in the curriculum
Authors: Baker Shari
Published: May 2014

Shari Baker explores how schools can access quality provision from the creative industries and considers what support is available to help increase creativity within their own curriculum.
Communicating success Networking for your school
Authors: Dalton-Brown Lloyd
Published: May 2014

Fundraising campaigns are often dependent on having good links with the community. In the first of a new series, Lloyd Dalton-Brown gives some tips on building positive relationships with new contacts.
Funding partnerships How successful are they?
Authors: Lepkowska Dorothy
Published: May 2014

Five years after the first federations were set up, Dorothy Lepkowska considers how well inter-school collaborations work in reality.
The Wolfson Foundation A family's legacy
Authors: Maiden Andrew
Published: May 2014

One family's foundation has been committed to supporting education for well over half a century. Andrew Maiden profiles the work of the Wolfson Foundation.
Everyclick Making IT work for you!
Authors: Youngman Angela
Published: May 2014

Angela Youngman profiles the search engine and reveals how it can be used to raise money for your school.
Fundraising story: Calling in the experts
Authors: Youngman Angela
Published: May 2014

Angela Youngman talks to PTA chair Liz Rayment about how her school succeeded in raising £50,000.
On the agenda: The voice of experience
Authors: Griggs Amy
Published: May 2014

Welcome back to the start of a new academic year. This month we have articles from two people who work, or have worked, in schools for many years. They both have hands-on knowledge of the kind of financial problems schools face, and offer up some practical solutions.
Cutting costs: He who shares, wins!
Authors: Elkin Susan
Published: May 2014

Susan Elkin discusses some of the benefits of sharing resources with other schools and organisations in your locality.
Right from the start: Audit, monitor, evaluate
Authors: Baker Shari
Published: May 2014

Shari Baker helps schools understand the why and how of auditing, monitoring and evaluation, and discusses why the end of a project is a great place to start!
Alumni fundraising; A capital plan
Authors: Healey Francine
Published: May 2014

Many more schools are now recognising the value of a development office. Francine Healey explains the benefits and discusses how her school acheived success in their capital campaign.
Funding principles for: Efficient fundraising
Authors: David Anthony
Published: May 2014

Anthony David, an experienced school fundraiser, gives some practical tips on organised planning and explains how working across departments is key to financial success.
Top tips for: Getting something for nothing
Authors: David Anthony
Published: May 2014

Anthony David makes some suggestions for getting the local community involved in helping your school.
Take a book!; Funding at your fingertips
Authors: Maiden Andrew
Published: May 2014

Finding a funder for your project is a difficult job. Andrew Maiden provides a shortlist of some of the leading publications to help with advice and sources of grant-makers.
Teaching economic well−being Saving for a rainy day
Authors: David Anthony
Published: May 2014

Anthony David explains how getting pupils and parents involved in fundraising events can help foster an understanding of economic well-being.
The role of research Some funding options
Authors: Baker Shari
Published: May 2014

Shari Baker explores the research options available to schools, how to benefit from funding, and where to access it.
Dash for cash! Introducing Team Superschools
Authors: Youngman Angela
Published: May 2014

Getting children interested in sport is not always easy, which is why fundraising events organised by Team Superschools are proving successful in more ways than one.
Children's voices Funding for the curriculum
Authors: Baker Shari
Published: May 2014

Shari Baker discusses the potential for incorporating social-networking and on-demand media into the school curriculum, what resources are available, and how to get funding.
Beyond the school gates An alternative curriculum
Authors: Baker Shari
Published: May 2014

In our current climate, pupils about to leave school may be feeling a little nervous about the 'next step'. Shari Baker looks at some alternative options available to schools and pupils that may provide inspiration and access to more unconventional lifestyle choices. This should make the transition from school leaver to confident, influential members of society a little less daunting.
Are you getting something for nothing?
Authors: Baker Shari
Published: May 2014

Shari Baker looks at how schools can access much of what they need, without spending a penny!
Supporting students Bridging the funding gap
Authors: Baker Shari
Published: May 2014

Shari Baker looks at alternative funding sources which may help schools, and the families of children with special educational needs.
Going, going, gone! A bid of fun, part 2
Authors: Youngman Angela
Published: May 2014

Angela Youngman explains how your school can set up an online auction to turn a profit.
Knowing the ropes: The Gift Aid Scheme
Authors: Hellings Jane , Hadley David , Kingston Smith
Published: May 2014

Getting to know the rules surrounding the Gift Aid Scheme can enable you to make claims you would not have thought possible. Jane Hellings and David Hadley explain how Gift Aid can improve school fundraising.
Public health and acute care nursing
Authors: Eilbert Kay
Published: May 2014

This is the first of two articles that will outline the role of public health and the importance of partnership working, and describe some of the opportunities available to acute care nurses for promoting health improvement. Public health is defined, along with the three domains and competencies of public health. Participation in a ′Healthier Hospital′ scheme is proposed as a way for acute care nurses to promote public health within their work settings.
Time to have your say
Authors: Griffiths Helen
Published: May 2014

With Gordon Brown taking over the helm at 10 Downing Street, despite the political rhetoric I am sure that we are all wondering what possible changes lie in wait for the NHS.
What the journals say
Authors: Williams Julia
Published: May 2014

For some time, evidence has demonstrated the connection between dysplasia, increased cancer risk and ulcerative colitis; in contrast, however,the risk of cancer in Crohn′s disease has never been well defined. The authors undertook a meta−analysis with the purpose of identifying the risk of intestinal, extra−intestinal and hemopoietic malignancies in Crohn′s disease. In doing so the authors compared them to the baseline population to offer some clarity with regards to the risks for this particular group of patients. A review of the literature identified 34 studies of over 60 000 patients with Crohn′s disease around the world.
what the journals say
Authors: Williams Julia
Published: May 2014

The NHS Cancer Plan (Department of Health, 2000), Improving Outcomes guidance (National Institute for Health and Clinical Excellence, 2001) and the NHS Modernisation Agency′s 10 High Impact Changes (2004) will all ultimately affect the way future cancer care is delivered. They have been developed to ensure quality assurance of services, allowing for growth and development. Acknowledging that the clinical nurse specialist plays a pivotal role within the cancer team, providing expert knowledge to ensure the delivery of high-quality standards of care, the authors take this opportunity to explore specific areas of the cancer pathway.
A new era for GIN
Authors: Porrett Theresa
Published: May 2014

This issue of GIN sees us saying goodbye to Christine Norton who has been Associate Editor for some considerable period of time. I am sure you will join me in thanking Chris for the way that she has steered the development of the journal and consolidated its position as the leading journal for nurses working in the field of gastroenterology. It is with some trepidation that I take over the role of Associate Editor and I am under no illusions as to the size of the shoes I am trying to fill!!!!
Implementation of an IBD nurse−led self−management programme
Authors: Stansfield Catherine , Robinson Andrew
Published: May 2014

Approaches to chronic disease management have changed immensely over the past decade. Patients are no longer seen as passive recipients of care, and there is an expectation that those with chronic disease, such as inflammatory bowel disease (IBD), can be empowered through self−management programmes, which give them the confidence, skills and information to manage their condition independently. This article discusses the implementation of a guided self−management programme for patients with IBD by a specialist nurse.
Support for stoma patients
Authors: Moffat Polly
Published: May 2014

This issue features an article addressing the National Institute for Health and Clinical Excellence (NICE) guidelines on the management of faecal incontinence in adults (NICE, 2007). In this article (p 12), the author sets out key priorities for health care professionals in implementing the guidance and explains how the relevant documents issued by NICE should be used to provide the best care for patients suffering from this debiliating condition. Faecal incontinence can cause individuals to cope with their symptoms alone, often due to embarrassment and an unwillingness to seek help from the health service. As mentioned in the news section of GIN this month (p 4), NICE have decided not to recommend the use of infliximab in patients with sub−acute moderately−to−severely active ulcerative colitis. This is another example of a drug that could be used to benefit patients that is unavailable because it is not considered to be cost−effective. According to the guidance issued, a sub−acute manifestation of moderately−to−severely active ulcerative colitis is defined as disease that would normally be managed in an outpatient setting and that does not require hospitalisation or the consideration of urgent surgical intervention.
Assessing the value of a pre-transfer meeting in IBD transition services
Authors: Irvine T , Srinivasan R , Casson DH , Auth M , Crook K , Leiper K , Rhodes J , Greeg A , Kneebone A , Dalzell AM
Published: May 2014

Background: The benefits of a well-managed transition for adolescents with inflammatory bowel disease (IBD) are being increasingly recognized. However, there is limited evidence to support effective means of transition. Patient feedback is important to establish the value of such services. This survey looks at how young people with IBD and their families perceived the effectiveness of a model of transition and what improvements were needed. Design: Postal questionnaire survey. Setting: Transition between paediatric services at Alder Hey Children′s NHS Foundation Trust, Liverpool and the Royal Liverpool University Hospital (adult centre). Population: Young people (adolescents) who had been through the transition process between the above centres from 2003-2008. Interventions: A semi-structured questionnaire survey designed to obtain patient feedback on transition care arrangements and provision of service. Main outcome measures: Patient information, satisfaction and suggestions. Results: 35 of 66 families returned the questionnaire. High rates of satisfaction were reported (33/35; P<0.001-sign test). Feedback included provision of adequate information, opportunity to discuss change (P<0.001) and reduction in perceived anxiety about the transfer (P=0.08).Conclusions: High rates of satisfaction with transition incorporating a pre-transfer meeting were expressed
Understanding the challenges and management of paediatric stomas
Authors: Bennett Yvonne
Published: May 2014

As with adult patients, stomas are formed in children as a life-saving technique or to improve their quality of life. It is unsurprisingly a shattering experience for parents to be told that their baby or child requires a stoma (Webster, 1985), and the role of the paediatric stoma care nurse includes supporting the family and teaching the parents how to care for their child′s stoma (Kean, 2002). Yvonne Bennett provides an overview of the practical aspects of paediatric stoma care, highlighting the main challenges and appropriate management.
Patient outcomes and quality of life following stoma-forming surgery
Authors: Boyles Anna
Published: May 2014

For some patients, the formation of a stoma marks the beginning of a long path of treatment, while for others it may come at the end of years of intervention, medication and treatment, and mark a return to a more normal lifestyle. Either way, stoma formation will impact on patients and the way they live their lives. As nurses caring for this group, it is important to consider the problems they face and how they adapt to their new way of living. In this article, Anna Boyles examines the psychosocial impact of stoma formation and its influence on patient outcomes in terms of their self-perception and quality of life.
Capnometry vs pH testing in nasogastric tube placement
Authors: L Miller Shelley
Published: May 2014

Nasogastric tubes (NGTs) are commonly used in the clinic for feeding, aspiration and administration of drugs and other oral agents. It is therefore imperative that NGTs are correctly placed in the stomach. Carbon dioxide detectors could be beneficial to use in conjunction with traditionally standard bedside verification techniques such as pH testing, direct visualization of gastric contents on aspiration, and air insufflations with auscultation. In this article, Shelley Miller comparatively analyses the current research related to the accuracy of verifying NGT placement with carbon dioxide detectors and pH testing. She concludes that carbon dioxide detectors are no more accurate than pH testing in confirming correct NGT placement.
Ageing and C. difficile infection—the immune and gastrointestinal impact
Authors: Banning Maggi
Published: May 2014

It is suggested that age-related changes in the immune response, particularly the antibody and cell-mediated immune response, gut microflora and gut physiology, render older people susceptible to infections. Clostridium difficile is a common gastrointestinal infection which infects patients in hospitals and long-term care institutions. Infection with antibiotic associated C. difficile can cause a range of symptoms from mild diarrhoea to life-threatening colitis, often causing relapse and re-infection. In this article, Maggi Banning discusses the effect of ageing on the gut, the symptoms and treatment of C. difficile infection in older people and infection control methods.
Body mass index estimation from waist, neck and mid-arm circumference
Authors: Marshall Anwen R , Haboubi Nadim , Jones Sian
Published: May 2014

With obesity becoming increasingly common, a more accurate and practical way to measure body mass index (BMI) and thus obesity is required. In this article, Anwen Marshall, Nadim Haboubi and Sian Jones investigate whether waist, mid-arm and neck circumference, and Epworth sleepiness scale can be used to accurately estimate BMI and whether patients prefer anthropometric measuring or weighing.
The management of feeding gastrostomies
Authors: Forest-Lalande Louise
Published: May 2014

Enteral feeding has become a feeding route of choice to ensure adequate nutritional intake. However, peristomal skin or tube-related complications may interfere with the patient's quality of life. In this article, Louise Forest Lalande provides potential solutions to assist the caregiver in identifying the aetiology of the problem in order to prevent and optimally manage any complication.
Zollinger-Ellison syndrome
Authors: Moore Andrew Robert , Varro Andrea , Pritchard Mark
Published: May 2014

Zollinger-Ellison syndrome is characterised by severe, recurrent peptic ulceration, gastro-oesophageal reflux and diarrhoea. It results from the overproduction of gastric acid, due to production of the hormone gastrin by a secretory tumour, or ‘gastrinoma’. These rare neuroendocrine tumours are most commonly found in the duodenum or pancreas. Most gastrinomas arise sporadically but in a quarter of cases occur in association with multiple endocrine neoplasia type 1 (MEN1 syndrome). In this article, Andrew Robert Moore, Andrea Varro and Mark Pritchard outline the diagnosis and treatment of gastrinomas and the associated Zollinger-Ellison syndrome. The symptoms of this condition can now usually be well controlled with acid-suppressing drugs; hence, prognosis is primarily determined by tumour-related factors.
Quality of life after ileo-anal pouch formation: patient perceptions
Authors: Perrin Angie
Published: May 2014

This article describes a qualitative study, exploring the experiences of six individuals who have undergone an ileo-anal pouch formation and their subsequent lifestyle after this reconstructive surgical procedure. The aim of this study was to ascertain whether individuals who had an ileo-anal pouch believed themselves to have a good quality of life and a lifestyle that was not compromised as a result of surgery. The themes that emerged through the interviews were common to several participants and refected their life, the decisions they were required to make and the resources available in order for them to do so. The outcome of this study, using a phenomenological approach, highlights that some individuals restrict their lifestyle, while others do not and are prepared to live with the consequences. The literature overwhelmingly concludes that the ileo-anal pouch procedure is a safe and effcient procedure with high patient satisfaction and good functional outcome, which should be recommended as a long-term option for ulcerative colitis and familial adenomatous polyposis sufferers. However, some patients curtail their lifestyle by restricting diet, altering meal patterns and minimising social activities to maintain day-to-day living with an ileo-anal pouch.
Evolving the role of the stoma care nurse to support the expert patient
Authors: Buckle Nick
Published: May 2014

A patient-centric NHS has been the ambition of successive governments. Today, patient empowerment is a core principle of the NHS, with the NHS Constitution declaring its support for individuals in managing their own health. Patients, catalysed by the ease of access to advice and information through the internet, also have increased expectations of the standard of care they receive and look to specialist nurses to provide direction. The role of the stoma care nurse (SCN) is pivotal in ensuring both the delivery of the NHS ambition and the standard of care expected by ostomists. SCNs have continually evolved their role to enhance the patient experience by becoming autonomous practitioners, and many are now nurse prescribers. This article discusses how a further evolution of the SCN role to incorporate ‘health coach’ as part of the offering supports the expert patient and empowers individuals to manage their own health.
Communicating the value and complexity of our work
Authors: Porrett Theresa
Published: May 2014

Theresa Porrett, Senior Medical Manager, Ostomy Division, Coloplast Ltd, talks about the recently launched Apollo Nursing Resource
A case of claudication in a young man
Authors: Jaffer Usman , Cameron Alan
Published: May 2014

A 37-year-old man presented with a 2-month history of right-sided calf pain when he walked. This had started suddenly. The pain was forcing him to stop after 5 minutes of walking and subsided following a prolonged period of rest. He smoked 5 cigarettes a day, but had no other risk factors for peripheral vascular disease.

On examination of his peripheral vascular system the right posterior tibial and dorsalis pedis pulses were absent and the popliteal pulse was markedly diminished compared to the left. Femoral pulses were present and there were no other stigmata of peripheral vascular disease.

A femoral angiogram was performed which demonstrated a normal aorta, iliac and femoral vessels. There was a short occlusion of the distal right popliteal artery for a segment of 3 cm with a smooth rounded filling defect arising from the anteromedial wall of the popliteal artery just above the occlusion (Figure 1).

Exploration of the popliteal artery revealed a cyst arising from the above knee popliteal artery which was incised, expressing clear fluid similar to that found in joint ganglia. A short jump graft using the long saphenous vein was fashioned around the occluded segment with good symptom relief. Histological examination of the cyst wall showed fibrocollagenous connective tissue devoid of an epithelial lining. A diagnosis of cystic adventitial disease was made.
Gulf War illness
Authors: Deahl Martin
Published: May 2014

Fifteen years after the first Gulf War, more than 6000 British veterans of the conflict (11% of those deployed) have developed a variety of disparate, seemingly unrelated, unexplained chronic, enduring, and sometimes disabling physical, cognitive and psychological symptoms. A similar proportion of USA service personnel have been similarly affected. Considering that most of these individuals were previously fit to be deployed on military operations it is not surprising that many have attributed their complaints to Gulf service.
A new classification for outcomes in illness and injury
Authors: McPherson Kathryn , Ferguson Laura , Levack William , Kersten Paula
Published: May 2014

Illness and injury can lead to complex problems for patients and clinicians. A new approach from the World Health Organization (WHO), the International Classification of Functioning, Disability and Health (ICF), may help manage such patients, and evaluate the success of the interventions used. The authors discuss the application of the ICF model.
Cardiac valvulopathy
Authors: Schachter Michael
Published: May 2014

These colour doppler images are from the cardiology unit of Professor Guy van Camp in Brussels, whose paper last year (2004) drew attention to the association between restrictive valvular disease and the antiparkinsonian ergot derivative pergolide. Figures 1–2 show abnormal valves in patients treated with this drug.
Where now for the management of osteoporosis?
Authors: Fogelman Ignac
Published: May 2014

Osteoporosis is a metabolic bone disorder, leading to bone fragility and fracture. Recent guidance from the National Institute for Clinical Excellence (NICE) emphasizes the importance of secondary prevention of fragility fractures in postmenopausal women. What impact can the expanding range of treatments make on the growing and costly burden of osteoporosis?
Hospital disciplinary procedures
Authors: Stewart Hugh
Published: May 2014

This article welcomes the end of suspensions for hospital doctors under the old disciplinary procedures and examines the new disciplinary framework.
Extranodal lymphoma: clinical presentation and diagnostic pitfalls
Authors: Shine Neville P , Blake Simon P , O'Leary Gerry
Published: May 2014

Non-Hodgkin's lymphomas (NHL) are known to present extranodally in 25% of cases, in contrast to Hodgkin's disease which rarely involves extranodal sites. In this article, the authors will to review the presentation of extranodal head and neck NHL and the difficulties that can be encountered in making the diagnosis in these cases.
Assisted reproductive technology: 25 years of progress
Authors: Forman Robert
Published: May 2014

Great strides have been made in assisted reproductive technology and nearly all forms of subfertility are now amenable to treatment. Constant advances in technology and ethical controversy ensure it has a high public profile. The impact of assisted reproductive technology will be discussed in this article.
Cardiovascular risk and anaesthesia: what is an anaesthetist to think?
Authors: Goodman Neville
Published: May 2014

The textbook (Churchill-Davidson, 1978) that I used for the FFARCS diploma, now the FRCA, was unequivocal: ‘The hypertensive patient represents an increased risk for anaesthesia and surgery.’ The opening paragraph of the section went on to speak of cerebrovascular accidents, myocardial infarction, and all manner of mischief. As with so much in medicine, the intervening years have seen certainty replaced by uncertainty, although uncontrolled or poorly controlled hypertension is still one of the main medical reasons that operations are cancelled on the day of surgery.
Death of a pioneer surgeon
Authors: Ellis Harold
Published: May 2014

One hundred years ago, on June 14 1905, Johann von Mikulicz- Radecki died, at the early age of 55 years, and the world lost a pioneer surgeon at the height of his achievements.
Late presentation of traumatic rupture ofthe right hemidiaphragm
Authors: Khalil Mohammed W , Sarkar Pradip K
Published: May 2014

A 30-year-old male Caucasian was involved in a road traffic accident, where he sustained a severe right chest injury. There was a 15 cm long laceration on the anterolateral part of the right chest below the nipple, which involved chest wall muscles but the intercostal muscles were intact. A chest radiograph revealed fractures of the posterior right eighth, ninth and tenth ribs, with associated haemopneumothorax for which an intercostal drain was inserted. Repeat chest radiograph revealed an elevated right hemidiaphragm. There were no associated abdominal injuries. The chest laceration was repaired under general anaesthesia, and the patient was later discharged.

He presented again 21 weeks later with persistent right chest discomfort, and a chest radiograph showed persistence of the right diaphragmatic elevation (Figure 1). A computed tomography scan of the chest and abdomen suggested a possible traumatic rupture of the right hemidiaphragm.

A right thoracotomy through the sixth intercostal space was performed. Multiple adhesions between the lung and the chest wall were dissected revealing a 7–8 cm tear in the diaphragm, with the right lobe of the liver protruding through it (Figure 2). The edges of the tear, which were thickened and fibrotic, were dissected free and closed primarily with interrupted mattress prolene-0 stitches without tension. These were then oversewn.

The patient did well and was discharged 5 days after surgery.
Manipulation and immobilization of Colles' fractures
Authors: Oussedik Sam , Haddad Fares
Published: May 2014

Closed reduction and immobilization within a plaster cast remains an acceptable treatment for the majority of distal radial fractures. In order to gain satisfactory results, it is important to carefully select which patients to manage in this manner.
Good Doctors, Safer Patients: a chance to move on
Authors: Catto Graeme
Published: May 2014

Sir Liam Donaldson's report, Good Doctors, Safer Patients, was published on 14 July 2006 and makes 44 recommendations (Department of Health, 2006a). The government is consulting on the report (and on a parallel report on the regulation of other health-care professionals) (Department of Health, 2006b). The statement from the General Medical Council (GMC) marking the publication of the report underlined that the starting point for the GMC in developing its response to the report is its statutory purpose – to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine ( www.gmc-uk.org ). The GMC expressed support for some of the proposals, said that others would need careful consideration, but warned that the proposals in relation to medical education, which would take away from the GMC's responsibility for undergraduate medical education, would not be in patients' best interests.
Vaccines against human papillomavirus: the future is bright
Authors: Brabin Loretta
Published: May 2014

Every year in the UK over 2800 women develop invasive cervical cancer and almost 1100 die (Cancer Research UK, 2006). Until recently, the main way to prevent cervical cancer was through cervical screening programmes. This is set to change. In September 2006, the first vaccine that can prevent cervical cancer (Gardasil, Merck and Co, Inc. New Jersey) was granted a European licence and a second vaccine (Cervarix, GlaxoSmithKline, Rixensart) should be licensed early in 2007. Both vaccines protect against HPV 16 and 18, the types of human papillomavirus (HPV) that account for about 70% of cervical disease (Harper et al, 2004; Villa et al, 2005). Gardasil additionally protects against HPV types 6 and 11 that cause genital warts. The United States Centers for Diseases Control has already recommended routine vaccination with Gardasil for 11- and 12-year-old girls, and for 9–10-year-old girls at the discretion of their physician. In the UK the Joint Committee on Vaccination and Immunisation is reviewing the use of HPV vaccines and their potential benefits.
Xenon as an anaesthetic gas
Authors: Baskar N , Hunter JD
Published: May 2014

Although expensive to manufacture, the inert gas xenon has many of the characteristics of the ideal anaesthetic agent. In particular, it confers haemodynamic stability and beneficial effects on organ perfusion. It also has a favourable pharmacokinetic profile allowing rapid induction and emergence. However, widespread clinical application will only be economically feasible if the cost of xenon falls and a low flow delivery system is used.
Unwarranted caution from the EU will affect MRI use and patient care
Authors: Young Ian , McRobbie Donald , Keevil Stephen , Taylor Andrew
Published: May 2014

A recent European Union (EU) Directive which comes into force in 2008 could have potentially unforeseen and damaging effects on clinical magnetic resonance imaging (MRI). The scientific basis for the Directive is weak, and leans heavily on the ‘precautionary principle’ in deciding its restrictions, while having little or no substance to support them. In April 2004, the EU Parliament enacted the first of three Physical Agent Directives, in this instance dealing with occupational exposure to electromagnetic (EM) radiation (EU Directive, 2004). Legislation implementing this Directive has to be taken on board by all EU member countries – including the UK – by 30 April 2008.
Gene therapy: has it delivered what it promised?
Authors: Kinnon Christine
Published: May 2014

Gene therapy was hailed in the late 1970s and early 1980s as the great ‘miracle cure’ for a wide range of diseases. With the increasing genetic knowledge and skills available it was possible to envisage a world where every genetically defined disease would be amenable to some sort of genetic intervention and potential cure. Although we have continued to make remarkable progress in understanding the genetic basis of disease, particularly through the success of the human genome project, many feel that the therapeutic improvements that were expected have failed to materialize.
Future fertility after conservation surgery for cervical cancer
Authors: Farthing Alan
Published: May 2014

Advances in surgical techniques have resulted in some women presenting with invasive cervical cancer being able to receive curative treatment while preserving their fertility. The pregnancy outcomes are acceptable and women who have not completed their families should have this option discussed.
A successful initiative for getting refugee doctors back into medical employment: the PRIME project
Authors: Ong Yong-Lock , Paice Elisabeth
Published: May 2014

Refugee doctors find it difficult to get back to medical work in their new countries. This article describes the setting up and evaluation of the Placing Refugee doctors In Medical Employment (PRIME) project which resulted in 15 out of 25 participants getting substantive jobs in open competition within a year, and suggests this approach should be more widely adopted.