bluuebunny/crossref_metadata_2025 huggingface dataset:
The religious calendar: online information and resources
Authors: Smyth Dion
Published: May 2014

As the Western Hemisphere shakes off the shivering winter woes and welcomes the warmth of spring, many of us will be observing particular festivities. Easter is now represented by both the secular and seasonal celebrations of blossoming fields and flowers, and the Christian religious remembrance of the Passion and Resurrection. (It is also and an excuse to eat chocolate eggs in the UK.) At the same time, the Jewish holiday of Passover, the Sikh festival of Vaisakhi and the Hindu festival of Shri Ram Navami will be commemorated. As the world and our working environments become more multicultural, an awareness of the major principles and practices of faiths and religions, as well as non-religious organisations, can improve the care we offer. This month’s Web Words looks at internet resources on the calendar of religious and spiritual events.
Loss and bereavement: a child’s perspective
Authors: Ling Julie
Published: May 2014

In the last couple of months, I have had two very different experiences of a child’s response to death. Smokey’s demise was a predictable event – for a goldfish, life has a short prognosis. As a palliative care nurse I was acutely aware that this was an opportunity to ensure that my six-year-old son was able to understand death and dying as a part of life. On noticing Smokey lying sideways in the water, I decided to fire the warning shot. ‘Smokey doesn’t look well’, I said. ‘Is he dead?’ was the reply. Later, Smokey was ceremoniously placed in the toilet and, without any prompting, my son blessed himself and said a little prayer before flushing Smokey’s remains into the Irish Sea. When I next went into the bathroom, there, above the toilet, was a handwritten note stuck on the tiles. It contained a few novel spellings, but the message read: ‘Smokey the fish. Great memories. Died 27th February.’
Mental capacity: online information and resources
Authors: Smyth Dion
Published: May 2014

The freedom and right to make one’s own decisions is a cornerstone of an egalitarian and uncensored society. However, when we become mentally incapable of determining such an action, the civilised state needs to protect the vulnerable and often weaker members of its populace. This month’s Web Words looks at material relating to the recently implemented Mental Capacity Act in the UK.
Raising the profile of palliative care
Authors: Moffat Polly
Published: May 2014

This issue is brought to you ahead of World Hospice and Palliative Care day on 6 October 2007. The day aims to celebrate and support hospice and palliative care around the globe, with a number of concerts and fundraising events taking place. The theme this year is palliative care across the ages, from children to older people. According to the WHO, the world’s population is ageing; in 2000, there were 600 million people aged 60 years and over, and it is predicted that these numbers will continue to increase year on year. Fifty to 75% of these will require palliative care (WHO, 2007). It is imperative that people with a life-limiting illness receive the care they need and deserve; unfortunately, this does not always happen, particularly in developing countries where hospice services are in short supply (Wright et al, 2006). To get involved with World Hospice and Palliative Care day, visit the website at: www.worldday.org
Evaluating the care of patients with malignant spinal cord compression at a regional cancer centre
Authors: Warnock Clare , Cafferty Christine , Hodson Suzanne , Kirkham Elizabeth , Osguthorpe Charles , Siddall Jan , Walsh Rebecca , Foran Bernadette
Published: May 2014

The consequences of malignant spinal cord compression (MSCC) can be devastating. If not detected early, MSCC can result in paralysis and significant bowel and bladder dysfunction that is not improved by treatment. Patients have to cope with sudden and unexpected disability alongside a diagnosis of advanced cancer.

A multidisciplinary group was established within a cancer centre to review the care of patients with MSCC. Two linked studies were carried out: a staff questionnaire sent to senior medical staff and all nurses and an audit of documentation. The documentation audit reviewed the notes of 50 patients who had received radiotherapy for MSCC. The symptoms patients presented with on admission and before discharge demonstrated that many experienced significant physical problems as a consequence of developing MSCC. Usually, these symptoms were either unaffected by treatment, or had deteriorated further by the time of their discharge from hospital. The average number of days between admission with MSCC and death was 58.6 days (range 2 to 319 days). The project identified variations in practice in a range of aspects of care and provided clear evidence for the need to develop interventions in relation to specific concerns.
Involving and engaging patients in cancer and palliative care research: workshop presentation
Authors: Johnston Bridget , Forbat Liz , Hubbard Gill
Published: May 2014

This article is based on a workshop facilitated by the authors at the Palliative Care Congress, Glasgow 2008. The paper has three components. Firstly, setting the scene by describing a range of methods of involving people affected by cancer in research. Secondly, presenting data from a study of the experiences of people with cancer at the end of life that involved people with cancer at various stages of the research. Finally, describing the discussion from workshop participants on how we can involve patients with life-limiting conditions more in our practice and research.
Holistic assessment of cancer patients’ pain: reflections on current practice
Authors: Locker Sarah
Published: May 2014

This article explores the holistic assessment and management of pain for palliative care patients through the use of a case study. Using literature searching and reflection on current local practice, issues within pain assessment and management for cancer patients are identified. These issues include communication, opioid misconceptions, disease progression associated with increased pain, and the need to address all components of cancer patients’ total pain. Reflection on practice has highlighted that education, effective communication and multidisciplinary collaboration, and adaptation of an existing assessment tool to develop a multidimensional holistic approach to assessing pain, have the potential to improve quality of life for palliative care patients and their families.
Legalisation of euthanasia and assisted suicide: a professional’s view
Authors: Gannon Craig , Garland Eva
Published: May 2014

As probably intended, the recent IJPN article, Health professionals’ opposition to euthanasia and assisted suicide: a personal view (Vocht and Nyatanga, 2007) caused heated discussion at our multi-professional journal club. However, irrespective of personal views, there was united offence at the condemnation of all colleagues who hold differing views to the authors.
Cultural competence: a noble idea in a changing world
Authors: Nyatanga Brian
Published: May 2014

As British and other Western societies become more culturally and ethnically diverse, the need for cultural competence has never been greater. This involves all settings, including work, politics, home life and personal interactions, such as social gatherings. The idea of cultural competence has emerged as part of a strategy to increase the understanding of differences between cultures and thereby reduce potential disparities.
Meeting the spiritual needs of palliative care patients
Authors: Smyth Dion
Published: May 2014

Throughout history, mankind’s disparate communities and cultures have consistently recorded a fascination with the spiritual; a metaphysical concept that seeks to support some sense of our ultimate nature and purpose. While this perception is not necessarily or particularly aligned to the phenomenon of religious belief, architectural and archaeological artefacts, from the earliest cave paintings to the most modern cathedral church, attest to the fact that man has made manifest his beliefs in the form of an organised expression of religious faith.
Acupuncture as an optional treatment for hospice patients with xerostomia: an intervention study
Authors: Meidell Liv , Holritz Rasmussen Birgit
Published: May 2014

More than 70% of seriously ill patients with cancer suffer from xerostomia and the associated problems of swallowing, chewing and speaking. This study aims to investigate whether treatment with acupuncture is a viable option for hospice patients with xerostomia. During a 2-year period, 117 patients were assessed for xerostomia. Eighty-two patients were found to have moderate xerostomia. Sixty-seven fulfilled the criteria for inclusion. Of these, 14 were included but only eight completed the study. Ten acupuncture treatments were given during a 5-week period. The effect of acupuncture was measured using a visual analogue scale, and by measuring the saliva production before and after the series of treatment. The results show that all the patients experienced alleviation of dryness of the mouth and the associated symptoms, and thus benefited from the acupuncture treatment. However, conducting a 5-week acupuncture intervention study is not feasible at an inpatient hospice due to the patients being too close to death.
Finding meaning in distress
Authors: Smyth Dion
Published: May 2014

On 7th November this year, the Sunday nearest to the 11th day of the 11th month, at 11am, a quiet fell upon the UK, echoing the stillness and peace that came as the guns eventually fell silent in Europe as ‘the Great War’ ended in 1918. A remembrance service was held at the Cenotaph in London, just as it was in communities across the world, to commemorate the servicemen and women who died in the two World Wars and all the subsequent armed conflict. At this particular yearly service in London, various dignitaries and personnel from the armed and auxiliary forces, with a reverential public, congregate to pay respect to those who gave their lives defending the freedom of subsequent generations.
Can the palliative care services of today keep up and match the expectations of the ‘baby boomer’ generation?
Authors: Becker Robert
Published: May 2014

Much has been written in the popular media about the so-called ‘baby boomer’ generation; those people born in the 1950s and 1960s who, in many respects, are a unique generation. While the rise in smoking-related cancers, obesity, coronary heart disease and other lifestyle-related health issues have tragically cut short many lives, the average ‘baby boomer’ can confidently expect to live longer and with better quality than has ever been experienced before.
Podcasts and formal education: the scholarly value of the web
Authors: Smyth Dion
Published: May 2014

Online education, or e-learning, has seen exponential expansion over the past decade, as institutes of education recognize the learning potential and value, and possible marketing opportunities of being able to impart instruction and information in a web-based world. Podcasts represent an excellent way of conveying content from a course or conference and stimulating enquiry. Over the next few months Web words will explore the internet for scholarly podcasts relating to palliative care.
A description and comparison of palliative care services in the United Kingdom and Czech Republic
Authors: Švecová Katerina
Published: May 2014

National and international comparative studies on provision of palliative care are lacking and further research would be beneficial for the development of national policies and effective service frameworks in different countries. This literature review focuses on a comparison of the development, structure and provision of the palliative care services in the United Kingdom (UK) and the Czech Republic (CZ). The aim of the review is to find out if the systems used in each country could benefit the development of the services in the other. The historical development of palliative care services and frameworks and the current provision of palliative care services in the CZ and the UK will be described, analysed and compared. The challenges and constraints within the Czech and UK health-care systems preventing delivery of palliative care to all patients with palliative care needs will be identified. The aim is to provide the reader with a simple, but comprehensive picture of palliative care services within the UK and the CZ as they currently exist, offering a building block for possible future research.
Ways to remember
Authors: Smyth Dion
Published: May 2014

In the play The Importance of Being Earnest, Oscar Wilde wrote ‘Memory … is the diary that we all carry about with us’, and for many of us our ‘diaries’ are full of dates of recollection and reminiscence. Some of these dates will be personal, private and particular to our own circumstances; others will be more public and openly shared with the broader community.
’A softening of edges’: a comparison of yoga classes at palliative care services in New Delhi and London
Authors: Selman Lucy , Higginson Irene J.
Published: May 2014

Although the use of yoga as a complementary therapy is common in palliative care, there is little evidence regarding current practice to inform service provision and research. The aim was to explore and compare yoga classes offered by palliative care services in New Delhi and London. Semi-structured qualitative interviews were conducted with yoga teachers and participants at two services and analysed thematically. Participants were: in Delhi eight family carers, three patients, and two teachers; in London six patients, one teacher, and one assistant. Six key themes are described: content of classes, symptoms and problems, preconceptions and the meaning of yoga, effects of yoga, challenges, and recommendations. This is the first study to examine the experiences of patients and carers practising yoga in palliative care settings. Recommendations include supporting and educating yoga teachers working with this population, and the need for robust trials.
Fatigue in patients with advanced cancer
Authors: Hawthorn Maureen
Published: May 2014

In recent years, as treatment options for cancer sufferers have become more successful but also more exhausting, fatigue has become increasingly distressing and extreme for these patients. Despite this, the assessment and management of fatigue is frequently overlooked by health-care professionals. This article will focus on the assessment and management of cancer-related fatigue in patients with advanced cancer, assessing the evidence base in order to guide practice in a subject that poses a particular challenge to palliative care practitioners.
Psychological contracts of hospice nurses
Authors: Jones Audrey Elizabeth , Sambrook Sally
Published: May 2014

Psychological contracts have been described as individuals' beliefs regarding the obligations, expectations, and contributions that exist between them and their employer. They can be influenced by the organization's culture and philosophy, through human resources policies, and through the employee's personality and characteristics. Owing to the recent economic crisis, hospices in the UK are currently in a transitional phase and are being expected to demonstrate efficiencies that might be more in line with a business model than a health-care environment. This may conflict with the philosophical views of hospice nurses. To support nurses through this transition, it might be helpful to understand the antecedents of hospice nurses' behaviour and how they construct their psychological contracts. Failure to offer adequate support might lead to negative outcomes such as a desire to leave the organisation, poorer quality work, or disruptive behaviour. This study used a modified grounded theory approach involving in-depth interviews to explore the context and content of the psychological contracts of hospice nurses in the UK. Four main themes emerged: the types of psychological contracts formed, how the contracts are formed, their contents, and the breaches and potential violations the nurses perceive.
Can self-care become an integrated part of end-of-life care? Implications for palliative nursing
Authors: Johnston Bridget
Published: May 2014

This article will explore the concept of self-care in end-of-life care, drawing on data from a 2-year post-doctoral study conducted in Scotland.
Family carers' experiences of support at the end of life: carers' and health professionals' views
Authors: Dosser Isabel , Kennedy Catriona
Published: May 2014

This paper reports findings from an exploratory qualitative study concerning end-of-life support for family carers in an acute ward setting. The participants included bereaved carers of patients who had died in an acute ward or hospice, as well as health professionals. Interviews and focus groups were used to collect data. The study provides insights into the perceptions and needs of carers at the end of life and the challenges these present for nursing staff in an acute ward. This paper focuses on one key theme incorporating issues around communication between family and nursing staff and the availability of practical facilities. It provides information that may be beneficial to hospital staff who work in acute areas where there is an expectation they will support carers around the time of death.
Men’s experiences delivering palliative home health care in rural South Africa:an exploratory study
Authors: Campbell Laura
Published: May 2014

Aims: The study reported here formed part of a larger study that explored the experiences of health-care workers providing palliative care in patients’ homes in rural South Africa. This paper hones in on the experiences of male caregivers. Zulu culture has been strongly patriarchal and the gender of a caregiver may affect both patients’ and caregivers’ experiences. Methods: The study was exploratory, qualitative, and combined a visual methodology with unstructured interviews. The setting was a hospice and three home-based care organisations in rural KwaZulu-Natal, South Africa. Participants were a male Zulu nurse and two male informal home-based caregivers who have been trained in components of palliative care. Results: These male caregivers appeared to care deeply and altruistically for their patients and appeared to provide gender-appropriate care for male patients. Female patients were wary of being cared for by a man, for example having concerns that male caregivers may perpetrate physical abuse, including rape. Thus, challenges of being a male caregiver included the potential to not be appreciated by and/or to be subject to physical and verbal abuse from the community they serve. Conclusions: This study contests South African literature that presents male caregivers in a negative way. It emphasises a need to value and support male caregivers. The challenges faced by male caregivers are largely unexplored and further research is required as men could potentially play a valuable part in providing palliative care in rural homes.
Developing a long-term ventilation service in a children's hospice: an illustrative case study
Authors: Cockett Andrea
Published: May 2014

Children who use long-term ventilation at home and their parents find it difficult to access suitable respite services for short breaks. This article describes, through the use of a case study, a project to develop a respite service for such children at a children's hospice in England. The service development was a response to local need, which included a requirement to develop bespoke assessment documentation and processes as well as a comprehensive staff development package. The article follows the journey of one family through the development and use of the new service.
Burnout in nurses working in Portuguese palliative care teams: a mixed methods study
Authors: Pereira Sandra M , Fonseca António M , Carvalho Ana Sofia
Published: May 2014

Repeat contact with suffering, dying, and death is considered to be a risk factor for burnout among health professionals, particularly nurses working in palliative care. A mixed methods study was conducted to identify burnout levels, risk and protective factors, prevention strategies, and the emotional impact of working in palliative care among nurses in Portugal. A quantitative questionnaire was completed by nursing members of nine different palliative care teams and was supported by interviews and observation. Although the participants were exposed to risk factors, such as work overload, disorganisation, difficult relationships within the team and with patients' relatives, they showed a low risk of burnout. These results appear to be related both to the protective factors identified—namely the ethic of care in the relationship the nurses establish with patients, families, and within their teams—and to the preventive strategies they actively adopt for burnout prevention. The positive aspects of the nurses' roles help them to build a positive view of their work, which also promotes their own personal and professional development.
Developing clinical guidelines for end-of-life care: blending evidence and consensus
Authors: Dunning Trisha , Savage Sally , Duggan Nicole , Martin Peter
Published: May 2014

Background:

Developing clinical practice guidelines (CPGs) is challenging, particularly in areas that are difficult to research such as end-of-life care.

Aim:

To describe the process that staff in a large regional health-care service in Victoria, Australia, used to develop CPGs for managing diabetes at the end of life.

Method:

An interdisciplinary advisory group was appointed, a structured literature review undertaken, personal illness accounts sourced, and a guiding philosophy formulated. Individual interviews were conducted with people with diabetes and their carers. Formative and summative evaluation was undertaken.

Results:

No level I or II evidence was identified. The interviews yielded important information about how people wanted their diabetes managed. Formative evaluation enabled stakeholders to participate in developing the CPGs. The summative evaluation confirmed the CPGs are easy to use and appropriate to clinical staff.

Conclusions:

The CPG development process yielded the best current evidence on which to base care plans and person-centred CPGs.
Validation of the Japanese version of the Fatigue Barriers Scale (JFBS)
Authors: Komatsu Hiroko , Watanabe Chie , Yagasaki Kaori , Sakakibara Naoki , Nakamura Seigo
Published: May 2014

Background:

The Fatigue Barriers Scale (FBS) is an instrument to identify patient-derived barriers to fatigue management.

Objective:

To assess the reliability and validity of the Japanese version of the FBS (JFBS).

Methods:

Participants were 112 cancer patients. Reliability was determined through internal consistency using Cronbach's alpha coefficient and through test–retest reliability using Spearman's intra-class correlation coefficient (ICC). Construct, convergent, criterion-referenced, and concurrent validities were assessed. The Cancer Fatigue Scale (CFS), Patient Fatigue Knowledge Tool (PFKT), and Kessler 6-item distress scale (K6) were used for comparisons.

Results:

Cronbach's alpha coefficients were 0.74, 0.78, 0.72, and 0.54 for the JFBS total and for each subscale, respectively. All ICCs exceeded 0.65 (P<0.05). The JFBS had a weak negative correlation with the PFKT and a positive correlation with the CFS. The K6 scores showed weak positive correlations with the JFBS total and fatalism subscale scores.

Conclusions:

The JFBS can be used to measure fatigue barriers in Japanese people with cancer.
Politics and palliative care: Columbia
Authors: Smyth Dion
Published: May 2014

Dion Smyth's review of the internet for palliative nursing
Developing evidence-informed decision making in a hospice: an evaluation of organisational readiness
Authors: Morris Jenny , Stewart Amy , Richardson Janet
Published: May 2014

Introduction: Multiprofessional home care and hospice teams should play a part in evidence-informed decision making. Aims: To assess organisational readiness to adopt evidence-informed decision making in a hospice in England. Design: A mixed-methods approach was used. Clinical staff were surveyed regarding their attitudes to and skills in using evidence, and senior managers completed an organisation-based self-assessment tool recording the readiness of the organisation to embrace an evidence-informed focus. Results: 81% of the staff completed the survey. Staff were committed to the principles of evidence-informed decision making, but overall lacked the necessary knowledge and skills. Information obtained from the management self-assessment highlighted that a priority was to develop an evidence-informed decision-making culture focusing on education, training, and policy development. Conclusion: The process used in this evaluation may be applicable to other areas of health care when assessing an organisation's readiness to incorporate evidence-informed decision making into policy and procedure.
Using action research to investigate and improve hospice staff participation in workplace education
Authors: Griffith Sue
Published: May 2014

Finding ways to make good quality education available to all staff in an expanding and increasingly busy hospice organisation is a real challenge. Constantly providing learning opportunities that are then poorly attended owing to the pressure of work is equally disappointing, and leads to questions of cost-effectiveness. An action research project was undertaken to investigate the reasons for low attendance rates at learning events in one hospice. Having identified time and conflict with patient need as major issues, a second cycle of research using literature review and a survey methodology was conducted to find a contemporary and innovative solution to this problem in an attempt to establish a vibrant learning culture. As a result a virtual learning environment—ORACLE (Online Research and Care Learning Environment)—was created to augment the face-to-face sessions and provide staff with access to appropriate learning materials 24 hours per day, 365 days per year. Although unique to this organisation, ORACLE has potential application to any other work environment.
An evaluation of routine specialist palliative care for patients on the Liverpool Care Pathway
Authors: Thompson Jo , Brown Jayne , Davies Andrew
Published: May 2014

Introduction:

This report describes a service evaluation of the ‘added value’ of routine specialist palliative care team (SPCT) involvement with patients on the Liverpool Care Pathway for the Dying Patient (LCP).

Methods:

In the authors’ hospital, patients that are commenced on the LCP are routinely referred to the SPCT. They are reviewed on the day of referral and then at least every other day, depending on the clinical situation. The data for this report was obtained by reviewing the SPCT's clinical database and the patients’ LCP proformas.

Results:

The SPCT intervened in the care of 80% of 158 newly referred patients, e.g. for alteration of continuous subcutaneous infusion (23%) or alteration of use of non-pharmacological interventions (21%). Furthermore, 11% of patients were taken off the LCP, around one quarter of whom were later put back on.

Conclusions:

The authors’ model of care could overcome many of the issues relating to the LCP and would ameliorate the developing vacuum of care for patients at the end of life.
Time for change? An exploration of complexity in health-care practice
Authors: Sweeney Kieran
Published: May 2014

In everything that health-care professionals do, in every evidence-based procedure or service they deliver, they are practitioners of a particular philosophy. However implicitly, they embrace a particular view of the world and a preference for some types of knowledge to make sense of the world from that perspective.

In this article, the basis for the conventional world view held by health-care professionals is explored. Its basis in science is set out and compared to the development of two other traditions: naturalistic (giving rise to the principles of qualitative research) and complex (based on the non-linear dynamics of complex systems). At stake, in this challenge to the conventional explanatory model in health care, is the way in which three different types of knowledge have become recognized as relevant and acceptable. The conventional world view, and by extension the explanatory model inhealth care, is now challenged at its very core by the emergence of our understanding of chaos, complexity and complex adaptive systems. The nature of complexity and its relevance to professional practice is explored.
Pilot evaluation of an inpatient neurological rehabilitation programme
Authors: Guerrier Sue , Kneebone Ian
Published: May 2014

Evaluation systems for rehabilitation services are required so that financial providers, service users and those involved in service delivery can assess their efficacy. This article reports on a pilot study to assess a community hospital inpatient rehabilitation unit service, in terms of client change from admission to discharge, using routinely administered measures: the Functional Assessment Measure and the Northwick Park Dependency Scale. Cases considered were acute admissions, predominantly clients with neurological diagnoses. The measurements taken demonstrated a positive change in all areas assessed for the majority of clients. A minority of clients showed no change.

It is recommended that future evaluations incorporate goal-achievement measures, in order to assess whether the unit's services have helped clients to reach their specific goals, and consider clients' views of the service. It is also suggested that the financial impact of the service should receive attention and that variation coding might help to identify the reasons why some clients might not benefit from the programme.
An audit of an evidence-based assessment tool for the blue badge disabled parking scheme
Authors: Morrissey N , Guyan P , Alexander CM
Published: May 2014

Those who have difficulty walking are eligible for a ‘blue badge’, which gives extra parking rights. An evidence-based assessment was introduced to assess applicants' eligibility for this badge. The assessment consisted of an interview, symptom scaling, falls risk assessment (including functional reach) and a walk test. In total, 226 assessments were carried out in a 6-month period. The discriminant analysis using all parts of the assessment gave 95% compliance and a cross validation value of 88%.

Post-assessment, awards of badges decreased by 12% and appeals decreased by 25%. All parts of the assessment were found to be useful in helping to make a decision. Answers from the assessment could predict the eligibility for 88% of the time. Consequently, therapists' knowledge and experience is still necessary. Using a face-to-face evidence-based assessment reduced the potential for abuse, decreased the amount of appeals and made the decision-making process more transparent.
Hypermobility syndrome and developmental coordination disorder: Similarities and features
Authors: Kirby Amanda , Davies Rhys , Bryant Amy
Published: May 2014

Children with movement difficulties can follow a number of different pathways to reach a diagnosis. They may receive a diagnosis of developmental coordination disorder (DCD) after being referred to an occupational therapist or paediatrician via school or parents, because of functional difficulties that impact on activities of daily living, such as dressing and feeding, or because of an impact on education, such as writing and ball skills. In contrast, children may present to rheumatologists or physiotherapists for joint pain, dislocation or late developmental milestones. These children may subsequently be diagnosed as having benign joint hypermobility syndrome (BJHS).

This article contrasts and compares functional difficulties between these two groups and considers whether BJHS could be associated with DCD. In addition, the article considers whether there is the potential for not diagnosing or misdiagnosing these children through lack of awareness by professionals and because of differing assessment routes.

The data from this survey show that children with BJHS do have a range of functional difficulties similar to those with DCD, and discusses the implications of this for management by the different professionals involved, and the potential for further research.
Pulmonary rehabilitation: An interdisciplinary approach
Authors: Garrod Rachel
Published: May 2014

Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction. The obstruction is usually progressive, not fully reversible, and does not change markedly over several months (National Institute for Health and Clinical Effectiveness/The National Collaborating Centre for Chronic Conditions, 2004).
Improving hospital compliance with the Disability Discrimination Act through use of an audit
Authors: Singh Rajiv , Pentland Brian
Published: May 2014

The 1995 Disability Discrimination Act protects disabled people from discrimination in access to services, facilities and goods, as well as in education and employment. All hospitals have an inherent duty to enable access to services, but this will now be enshrined in law. As the health sector has most contact with disability, it may be expected that most hospitals would already be in a good position to comply with the Act, especially one treating many patients with disability. However, the authors of this article identified many problems in a rehabilitation hospital setting by means of a simple access audit in March 2004. Recommendations were made and by March 2005, considerable improvements had been made, costing £100 000.

This article details the results of the survey and the measures taken to improve compliance. It also discusses the constraints and opportunities to improve facilities for people with disability. Although many necessary changes will be expensive, not all problems identified require costly correction. Many simply involve a change in staff attitudes and practices. The authors recommend that all hospitals start to identify the changes needed under the Act by means of a simple access audit that can be carried out by hospital staff with no specialist equipment.
Increasing practitioner knowledge of falls in older people: Role of higher education
Authors: Newman Ann , Jensen Jan
Published: May 2014

This article sets the context and justifies the need for post-registration interprofessional education on the prevention and management of falls in the older person. It describes the collaboration involved in the development of an interprofessional module entitled ‘Assessment, management and reduction of falls in the older person’ at Canterbury Christ Church University College. The module content was based on evolving evidence from the National Institute of Clinical Excellence. The module was delivered for the first time in the academic year 2004–2005.

It is proposed to evaluate the effect of this module on practitioner knowledge, understanding and contribution to the delivery of an integrated falls service in 2006.
Does taping control the foot during walking for people who have had a stroke?
Authors: Hillier Susan L , Masters R
Published: May 2014

This pilot study investigated the potential effects of inversion-control ankle taping on the timing and distribution of plantar pressures in the hemiplegic foot during the stance phase of gait. Five subjects with residual left hemiplegia after stroke and equinovarus foot posture participated in the single-case design study. The Emed-AT-2 force plate system was used to measure and analyse specific plantar pressure variables, including time to heel strike, contact area and maximum mean pressure under the total surface of the foot. Subjective reports of functional gait were also recorded. Descriptive statistics were calculated for the analysis of results.

All subjects achieved earlier heel-strike under the taped condition. Changes in other gait parameters appeared to depend on the individual subject characteristics. This study has identified beneficial effects and further research is warranted to confirm the use of ankle taping as a quick and affordable gait re-education tool after stroke.
The Independent Living Scotland exhibition: A preview
Authors: Franklin Zoë
Published: May 2014

Scotland's leading homecare exhibition will offer allied health professionals (AHPs) the perfect opportunity to keep up to date with new products and the key industry topics when it returns to Glasgow's Scottish Exhibition and Conference Centre this month.
Meeting the education and training needs of rehabilitation support workers
Authors: Galloway Jo
Published: May 2014

Rehabilitation support workers are an increasing body of staff within health and social services. Support worker roles are evolving and developing in response to a number of influencing factors. Traditionally, these roles have encompassed the needs of the professional group that they are affiliated with. However, the rehabilitation support worker role is an emerging role that is claimed to facilitate enhanced interdisciplinary teamwork.
What measure of man
Authors: Whittaker Maggie
Published: May 2014

If you believe what the politicians say you might be forgiven for thinking that the only thing that matters these days is demonstrating that value for money has been provided, clinical needs have been met and targets reached. Therapists, to mention just one group of practitioners, are in danger of becoming obsessed with measurement and outcomes, often combining the two as outcome measures (Chartered Society of Physiotherapy, 2002).
Implementing evidence-based practice: A model for change
Authors: Plastow Nicola Ann
Published: May 2014

Evidence-based practice is a crucial part of professional conduct for practicing allied health professionals. Rosenberg and Donald (1995) identified the well-recognized four steps to evidence-based practice, which include identifying the clinical question, finding and critically evaluating the evidence and finally implementing the evidence.

To date there is a wide variety of literature available describing evidence-based practice and methods of critically evaluating the literature, however, there are few articles describing how to promote change on the basis of evidence found.

This article aims to outline a model for changing practice for health professionals at all levels of practice. The model uses broad organizational development and project management principles. It is applicable for managing change both within organizations and at an individual level and will be useful to a range of allied health professionals.
Psychoneuroimmunology and occupational therapy for inflammatory disorders
Authors: Mailoo Venthan J
Published: May 2014

The occupational therapy profession was founded in 1917 on the notion that occupations contribute to psychological well being and physical adaptation. The credibility of occupational therapy has been threatened because the scientific basis of this notion is not always evident. The focus of occupational therapy in many physical settings has therefore shifted away from its original ethos towards one of physical problem solving and discharge facilitation.

Psychoneuroimmunology (PNI) is a developing branch of science that provides a theoretical framework to support the profession’s return to its original ethos of using occupations to promote health. This paper is an analysis of psychoneuroimmunological evidence to support occupational therapy for inflammatory disorders. A broad literature search revealed mind-body inflammatory pathways including anatomical links, nerve growth factor, adrenocorticotrophin, cortisol, somatostatin and substance-P.
Tools for daily living: An equipment guide
Authors: Fernandes Tanya
Published: May 2014

Assistive equipment and devices should enable those with disabilities to engage in, and carry out every day tasks. There are many different types of tools available that can be employed within the home to make tasks such as, eating, drinking, getting up and down the stairs, in and out of the bath and bed much easier

This article will focus on the different areas of the home, looking at the most suitable types of equipment available that can be used to solve mobility issues and general impairments of function.
Using computers to help with the management of rehabilitation services
Authors: Enderby Pam , Palmer Rebecca
Published: May 2014

The influence of technology on all aspects of our lives is undeniable. In one decade, we have gone from very few people owning a mobile phone, to the majority of the population doing so. Additionally, mobile phones now have many other functions that the general public had no expectation of even 3 years ago.
The role of rehabilitation
Authors: Merfield Helen
Published: May 2014

There’s no doubting the benefits of rehabilitation and the importance of early intervention. But equally, there is still a lot of work to be done. Health professionals and insurers need a better understanding of the social and psychological factors involved in the rehabilitation process and to move away from applying a traditional medical model of rehabilitation.
A practical guide to wheelchair cushions
Authors: Collins Fiona
Published: May 2014

Selecting a cushion to interface with a client's wheelchair is as important as the features of the wheelchair itself, as it is essential to maintain a stable base of support.

This article discusses the relationship between sitting, posture and pressure damage and gives general guidance on the types of wheelchair cushion on the market and their respective properties.
The aptitudes of allied health professionals working in remote communities
Authors: Thomas Yvonne , Clark Michele
Published: May 2014

This study aimed to identify the aptitudes required in allied health professionals working in three different service delivery models serving remote locations in Northern tropical Australia. Eighteen allied health professionals including; dietetics, diabetes educators, occupational therapy, physiotherapy, psychology, podiatry, social work and speech pathology participated in this exploratory study using a narrative approach.

A range of aptitudes were identified and themed under the following headings: (1) being organized but flexible, (2) cooperation and mediation, (3) culturally aware and accepting communicators, (4) knowing the community, (5) resourcefulness and resilience and (6) reflectivity. Limiting factors were also deduced. Three of the themes are discussed in this paper.

The study found that allied health professionals working in remote settings identified as important personal attributes not necessarily valued in metropolitan settings. Recruitment processes and education programs need to recognize the importance of personal attributes as well as professional skills.
Working with Asian individuals: Advancing the New Zealand mental health workforce
Authors: Nayar Shoba , Tse Samson , Woh Wong Sai , Wali Renuka , Thapliyal Anil , Bhui Kamaldeep
Published: May 2014

In 2005, the Asian Mental Health Workforce Development Feasibility Project was published in New Zealand. A key recommendation from the report was for the development of an education programme to increase the workforce’s cultural responsiveness to address Asian individuals' mental health needs at a national level.

Drawing on models of teaching and learning and literature identifying cultural capability, and in consultation with service users and workshop participants, a two-day education programme was developed and implemented in four cities. Demand for the workshops was high and initial evaluations showed a positive response in terms of mental health professionals gaining knowledge and enhanced understanding of best practices when working with Asian individuals. However, this project has to be seen as a beginning towards implementing a training programme at a nation wide level.

The aim of this paper is to present the education programme and evaluation results as delivered across New Zealand.
Can the type of walking stick issued effect mobility, confidence or fear of falling?
Authors: Marston Adrian
Published: May 2014

A previous qualitative pilot study found that using a moulded handle stick (Fischer stick) compared to conventional sticks could improve mobility through increased confidence and reduced fear of falling in the elderly patient. However, this was not statistically significant to refer to the general population. The aim of this study was to provide the missing statistical data concerning increased confidence and reduced fear of falling when issuing sticks to elderly patients with ‘non arthritic hands’.

An inferential study of experimental design by randomized control trial, allocating participants (n=47 aged 60–90years mean 80years) into one of two groups – moulded stick or conventional stick. An objective measure ‘Timed Up and Go’ (TUG) detected changes in mobility, with the Likert Scale detecting the changes in confidence and fear of falling over a 6-week evaluation period.

The moulded stick group showed a significant increase in mobility, confidence and a marginally reduced fear of falling (P<0.001), compared to the conventional stick group that showed little or no change in all tests. This study infers statistical significance to the findings of the pilot study validating that there are substantial benefits in using a moulded handle stick over a conventional stick for the general elderly population.
The 2nd UK Stroke Forum delivers diverse programme of research and information
Authors: Radford Kate
Published: May 2014

The 2nd annual UK Stroke Forum was held in Harrogate from 4–6 December 2007, hosted by the Stroke Association. With in excess of 13 00 delegates, it was the largest multidisciplinary stroke conference anywhere in the world.
Making disability equipment ordinary: Choice, control and the retail model
Authors: Winchcombe Maggie
Published: May 2014

Research into the experiences of disabled people who use charitable funds to get the equipment they need for health or social reasons has brought the shortcomings of public services and professional practice into sharp relief. Findings have been substantiated by a government report on wheelchair services and have fed into government plans for major re-organization of community equipment services, within planned reforms to adult social care. The retail model, proposed by the Department of Health, is currently only being implemented in England and is not mandatory. Exploration of developments internationally would enlighten practitioners who are engaged in developing service delivery models.

This article discusses the implications of the issues raised by the reports and the proposed changes in social care, in relation to practice for therapists and other providers of community equipment in England. Wider availability via mainstream retail outlets will, far from diminishing the roles of health professionals, create greater awareness and take-up of this equipment and will allow professionals to work to their strengths as therapists and be truer to their codes of professional ethics, rather than ‘gatekeepers’ of the state purse.

Current practice will need to change in order for clients (patients) to achieve the outcomes they require from the intervention rather than those bound by organizational or professional concerns. This will require a shift in focus towards a partnership approach in which the experience and skills of the client are given equal weight with those of the practitioner.