bluuebunny/crossref_metadata_2025 huggingface dataset:
The rationale behind pressure-reducing equipment: 2
Authors: Maylor Miles E
Published: May 2014

This is the second of two articles on pressure reduction. It outlines some of the main issues underlying the methods of relieving pressure for the seated patient and discusses the importance of chair cover material relative to interface pressure, humidity and temperature.
Physiotherapists working as extended scope practitioners
Authors: Milligan James
Published: May 2014

This qualitative study investigates how orthopaedic specialist registrars perceive the role of the physiotherapist working as an extended scope practitioner. The study uses in-depth interviews in a ‘grounded theory’ approach to generate data and analysis. Respondents provided viewpoints relating to impressions of ability, supervision and risk of litigation. Results indicate that staff promote the role.
The importance of the role of clinical educator in physiotherapy
Authors: Bennett Rosalie
Published: May 2014

This study explores some of the perceived concepts of physiotherapy student supervision in clinical placements through investigation and analysis of the views of clinical educators and physiotherapy managers. The author found evidence to suggest that supervising is advantageous in many aspects of professional practice.
Recreation in stroke rehabilitation part two: exploring patients' views
Authors: Cowdell Fiona , Garrett Dawne
Published: May 2014

Part one of this article highlighted a lack of research that investigated patients' perceptions of the need for recreational activity while undergoing rehabilitation following stroke. This article investigates whether patients perceive a need for recreation while undergoing stroke rehabilitation in an acute hospital setting. Data were collected using individual interviews and analysed using constant comparison.

Participants explained how they had come to be in their current condition and described the ‘purgatory’ of having a stroke. They talked about the ‘lifelines’ that may help them recover sufficiently, one of which was recreation. Many of the findings from this study were congruent with those from other studies. However, this article highlighted a desperation that participants felt to undertake more activity and a desire to incorporate recreation into the rehabilitative milieu.
Provision of powered mobility equipment to young children: the Whizz-Kidz experience
Authors: Home Anne Marie , Ham Ros
Published: May 2014

Locomotion and other motor skills develop rapidly during the first 3 years of life and become the primary vehicle for learning and socializing. Children with physical disabilities are denied such developmental opportunities unless they are provided with powered mobility.

A retrospective survey of the experiences of children issued with powered mobility by the charity Whizz-Kidz is reported in this article.
Clinical education: a critical analysis using soft systems methodology
Authors: Rushton Alison , Lindsay Geoff
Published: May 2014

Clinical education is an integral component of health-care professional education, providing an essential bridge between the academic and clinical environments. A soft systems methodology provided a conceptual framework for structuring an analysis of clinical education. The literature search encompassed all major databases and manual searching of key journals for health-care professions.

Content analysis identified key themes, which included the balance between theoretical and clinical components of a course, timing of placements, assessment, models of placement, the supervisory process and the role of the clinical educator, student and the university tutor.

The analysis identified a paucity of good quality research, with both theory–practice and literature–practice gaps in existence. The literature also highlighted the necessity for change, and the need to develop theory and research. The findings reflect that a structured approach to address the issues raised by clinical education at individual profession and interdisciplinary levels is perhaps required.
The use of multisensory environments on children with disabilities: a literature review
Authors: Yuen-yi Lai C
Published: May 2014

The use of multisensory environments (MSEs) for educating children with learning disabilities has gained widespread acceptance in recent years. However, scientific research studies on the use of MSEs are limited. This article reviews the literature concerning the use of MSEs in the paediatric field to provide sensory stimulation, promote relaxation, manage behavioural problems and develop skills. Research methodology and findings of the studies are discussed.

The author discovered a paucity of scientific literature on the effects of MSEs in the paediatric field. Positive findings on the use of MSEs are reported by the researchers. However, owing to the limitation of sample size, diversity of experimental population and variety of dependent variables, the effect of MSEs is difficult to generalize. Therefore, results should be interpreted with caution. Conducting vigorous studies on MSEs with improved research methodology is recommended.
Water, water everywhere...
Authors: Jackson Abbi
Published: May 2014

Abbi Jackson suggests some ways you can make water play a regular feature in your setting.
Challenging times
Authors: Dawson Susanna
Published: May 2014

After the excitement of Bonfire Night, December’s challenge was to keep going without all the children getting Christmas overload early.
Safeguarding children: The big picture
Authors: Lindon Jen
Published: May 2014

In a new series, Jennie Lindon considers how you can protect the children in your setting.
EYFS: Turning childminders into CEOs?
Authors: White Wendy , McKenzie Simona
Published: May 2014

Two childminders offer some reflective thoughts on the Early Years Foundation Stage, Ofsted, the Government and the media.
Question time
Authors: Griffin Sue
Published: May 2014

I've heard a lot about using phonics to teach children to read. Could you explain to me what exactly this means and what the pros and cons are?
And the seasons they go round and round...
Authors: Hammond Paula
Published: May 2014

Paula Hammond offers a song about the seasons, and gives some follow up activity ideas.
Early Years Childminder of the Year 2008!
Authors: Griggs Amy
Published: May 2014

Child Care editor Amy Griggs talks to award-winning childminder Mary Morgan about food, flower pots and modern art.
Fun with felt!
Authors: Storey Brenda
Published: May 2014

Felt-making is an activity that can be adapted for all ages, from three-year-olds to adults. It is easy to set up, fun to do and has a satisfying end result.
Making a twig deal!
Authors: White Hilary
Published: May 2014

Hilary White looks at how a range of different materials can be used to create interesting artwork.
A brief guide to epilepsy and what you should know
Authors: Baker Rachel
Published: May 2014

Rachel Baker gives practical, informative advice to help anyone caring for a child with this condition.
A sign of the times: Storytelling with a twist
Authors: Slack Garry
Published: May 2014

Author Garry Slack discusses how sign language can become part of storytelling in your setting.
The SEF challenge!
Authors: Dawson Susanna
Published: May 2014

Grace, aged eight months, is now coming three days a week in preparation for Mum returning to work this month.
Every child's entitlement
Authors: Griffin Sue
Published: May 2014

In the first article of a new series on the issues surrounding equality and inclusion, Sue Griffin outlines why these are so important in the early years sector.
Small World Play
Authors: Stone Tunja
Published: May 2014

This series of articles, beginning with small world play, looks at play provisions — many of which are part of what is referred to as continuous provision under the Early Years Foundation Stage (EYFS). This means normally available, easily accessible activities and resources to which children can help themselves.
Schools and ghouls
Authors: White Stephie
Published: May 2014

There’s been much excitement in the household recently as Carolyn started secondary school.
Revealing ringworm
Authors: de Braal Bernice
Published: May 2014

Bernice de Braal takes a look at ringworm, the name given to a group of highly contagious, but very common fungal infections affecting the skin, scalp and nails.
Creative development
Authors: Riddall-Leech Sheila
Published: May 2014

This month Sheila Riddall-Leech looks at observations in the context of the last of the six areas of learning.
Getting gastroenteritis
Authors: de Braal Bernice
Published: May 2014

Bernice de Braal takes a look at gastroenteritis (the term given to stomach bugs), which is particularly common in under-fives.
Let’s talk about it!
Authors: Mountstephen Mary
Published: May 2014

SEN specialist Mary Mountstephen explains how you can support children with speech, language and communication difficulties.
Meeting magical March hares
Authors: Hammond Paula
Published: May 2014

Paula Hammond tells a seasonal tale, and gives some post-story activity ideas.
Bad behaviour and how to deal with it
Authors: Thornton Stephanie
Published: May 2014

What do you do when something the child in your charge does leaves you squirming with embarrassment? Dr Stephanie Thornton explains.
Greetings cards: Branching out
Authors: White Hilary
Published: May 2014

Hilary White ends her series on cards by looking at some related craft activities.
Travel games
Authors: Youngman Angela
Published: May 2014

Angela Youngman explains some games to get children learning about countries and cultures.
Easter bunnies
Authors: Garner Lynne
Published: May 2014

Each month Lynne Garner puts a different animal in the spotlight. She gives some facts and figures to get you started on a project and provides a practical activity to get your creative juices flowing! This month: rabbits and hares.
Talking, listening and understanding
Authors: Lindon Jennie
Published: May 2014

This is the first in a series about communication between adults within your professional life. This month Jennie Lindon will revisit some of the basics around talking with and listening to fellow adults. Each month she will also explore practical implications for good communication with the children in your care.
Share a story (or two)
Authors: Cruickshank Sarah
Published: May 2014

May is National Share-a-Story month and in this article Sarah Cruickshank suggests some stories (ideas provided by children, parents and childminders), and some ways to share them.
Songs and rhymes
Authors: Stone Tunja
Published: May 2014

Tunja Stone explains why nursery rhymes, finger plays and chants are an important part of early childhood education.
How to draw in Dad
Authors: Griggs Amy , Rice Charles
Published: May 2014

As Father’s Day approaches Child Care offers eight top tips for engaging with dads.
Back to babyhood: The insecure child
Authors: Thornton Stephanie
Published: May 2014

Sharing is one of those things that are crucial to successful interactions in early childhood. But it is not something that comes easily to the young...
Communication, language and literacy
Authors: Riddall-Leech Sheila
Published: May 2014

This month Sheila Riddall-Leech looks at observations in the context of the second of the six areas of learning.
Inspection Day! Creating a good first impression
Authors: Baber Jenny , Paul-Smith Sharon
Published: May 2014

Some practical tips to ensure your EYFS Ofsted inspection is a stress-free and positive experience.
A bit of an animal...
Authors: Youngman Angela
Published: May 2014

Angela Youngman reviews some games on the topic of furry friends.
Ladybird, ladybird...
Authors: Garner Lynne
Published: May 2014

Each month Lynne Garner puts a different animal in the spotlight. She gives some facts and figures to get you started on a project and provides a related practical activity. This month she puts a member of the insect family under the microscope.
Lazy days in the shade
Authors: Jackson Abbi
Published: May 2014

Abbi Jackson provides some ideas for quiet time out of doors.
The anorexic patient: what options do we have?
Authors: Clarkson Jennifer , Tappin Simon
Published: May 2014

Anorexic patients are commonly seen in veterinary hospitals for a variety of reasons. Often the focus is rightly on finding and treating the underlying cause; however, in many instances, providing early and aggressive nutritional support can lead to improved and hastened recoveries as well as shorter hospital stays. This article discusses the management of anorexic patients, and reviews the placement of feeding tubes and the use of parenteral nutrition.
Small Animal Review
Authors: Tennant Bryn
Published: May 2014

Introduction: Dyspnoea, hyperkalaemia, and serum pancreatic lipase immunoractivity concentration at the time of admission are significant prognostic factors for cats with pancreatitis
Pain assessment in small animal practice
Authors: Hunt James
Published: May 2014

Despite rational perioperative analgesic prescription, a proportion of feline and canine patients will experience moderate-to-severe pain. Species-specific acute pain scales can be used to identify animals requiring further analgesia, and examples of validated pain scales are presented. Persistent pain may result in more subtle behavioural changes, which are often masked in a clinic environment, but are very amenable to assessment by owners following appropriate training from the veterinary and nursing team involved in the care of the patient.
Seizure management in dogs and cats: first-line drugs
Authors: Stefani Alberta de
Published: May 2014

With a growing number of anti-epileptic medications becoming available on the market, it is easy to loose track of how we should best treat our seizuring patients. This article provides an overview of the three first-line anti-epileptic medications, and guidelines for their safe use.
Practical exotics: how to bleed a lizard
Authors: Chitty John
Published: May 2014

Venipuncture is an essential technique in lizard medicine and, with practice, is readily achievable. This article will demonstrate different venepuncture techniques that may be utilised in practice
Two score years and five – that's dedication
Authors: Croser David
Published: May 2014

David Croser and his team of nurses have been working together for a combined total of 45 years. Dental Nursing finds out the key to such a successful relationship.
Take a seat: evolution of the dental chair
Authors: Ainsworth Steve
Published: May 2014

The dental chair has evolved from a basic piece of equipment to a marvel of engineering, design and ergonomics. Steve Ainsworth investigates the development of this integral part of modern dentistry and tells us about some of the key figures involved in the process.
The multidisciplinary management of hypodontia
Authors: Jones Steven P.
Published: May 2014

Hypodontia is a genetically determined disorder characterized by the congenital absence of one or more permanent teeth. In this article, Steven P. Jones describes its prevalence, aetiology and management.
Repairing traumatic injuries in immature non-vital teeth
Authors: Bhatia Shannu K , Syed Nasser , Chadwick Barbara
Published: May 2014

Mineral Trioxide Aggregate (MTA) is a dental material which allows a one-visit apexification and is considered an effective alternative to calcium hydroxide. It is important for the whole dental team to understand the clinical techniques used and the materials involved.
Nurses have their say at the ADI Team Congress
Authors: Schaeffer Bill
Published: May 2014

The Association of Dental Implantology (ADI) welcomes you to the second edition of Implantology in Practice..
A day in the life of an implant nurse
Authors: Anderson-Sharkey Susie , Fletcher Louise
Published: May 2014

Susie Anderson-Sharkey, practice manager at Dental fx, talks to the head implant nurse, Louise Fletcher, about the important role they have in the dental practice. The responsibilities and day-to-day tasks are described and Louise explains why implant nursing is such an enjoyable career.
The diagnosis of early and premalignant lesions of oral squamous cell carcinoma
Authors: Brock Gareth
Published: May 2014

Brocklehurst PR, Baker SR, Speight PM (2010) A qualitative study examining the experience of primary care dentists in the detection and management of potentially malignant lesions. 2. Mechanics of the referral and patient communication. Br Dent J 208(2): E3 and E4
Implementing a treatment coordinator in your practice
Authors: Horton Laura
Published: May 2014

If your practice offers not just maintenance dental care, but also more aesthetic and elective dental options, then you could benefit from introducing a treatment coordinator into your practice. This article outlines the role of a treatment coordinator, and how this can improve a practice's case acceptance and patient relations.
Implant technology and the dental nurse
Authors: Crabb Claire
Published: May 2014

While dental implants have been around for decades, recent advances in technology and treatment protocols have made treatment more convenient, more effective, and more affordable. This article outlines how advances in implant technology have impacted on the dental nurse's role.
Molar incisor hypomineralization
Authors: Willmott Nigel
Published: May 2014

Molar incisor hypomineralization requires careful management if the affected child is to have the best possible outcome. Nigel Willmott outlines the prevalence, aetiology and treatment options for this common condition
Managing the risk of sensitisation to latex
Authors: Kinay Aleks
Published: May 2014

Healthcare staff with a high occupational exposure to latex gloves, such as dental care professionals, have a higher than average incidence of latex allergies. Aleks Kinay outlines the types of allergic sensitization to natural rubber latex and measures to reduce the risk of exposure in health services
Orthodontic care for patients with epidermolysis bullosa
Authors: Green James
Published: May 2014

Epidermolysis bullosa (EB) is a diverse group of disorders with blister formation in response to mechanical trauma. Patients with EB requiring orthodontic treatment need special consideration
Risk of aerosol contamination around the dental chair
Authors: Freeman Julia
Published: May 2014

Most procedures performed by the dental team have the potential for creating contaminated aerosols and splatter. These aerosols represent an infection hazard due to their gross contamination with microorganisms and blood. This article outlines how aerosol contamination can be reduced
An overview of saddle seats and their benefits in dentistry
Authors: Westley Helen
Published: May 2014

Musculoskeletal disorders, including repetitive motion injuries, result in painful work, lost workdays, and, in extreme cases, disability resulting in forced retirement disorders. That's why it's so important that you choose an ergonomic seat which ensures that the pelvis is properly positioned and stabilised
Dry mouth — a review of this common oral problem
Authors: McMillan Roddy
Published: May 2014

Oral dryness can lead to significant problems, such as tooth decay, infection and impaired quality of life. This article provides a comprehensive overview of dry mouth, including the role of saliva in health, causes and management of dry mouth, and the role of dental care professionals in dry mouth
Antibiotic resistance and how to act on it
Authors: Cope Graham , Cope Anwen
Published: May 2014

Bacteria becoming resistant to antibiotics is a natural phenomenon but is made worse by suboptimal and unnecessary use of antibiotics. Changes to dental prescribing practices and patient education are needed to resist this problem
Dealing with teething in children
Authors: Harris Christine
Published: May 2014

It is commonly believed that teething in infants can cause various signs and symptoms. This article reviews the evidence for the various suggested signs and symptoms as well as suggested remedies
A comparative overview of dental adhesives
Authors: Rahman Naomi , Mulcahy Mike , Lewis Nick
Published: May 2014

The advent of bonding agents has led to major changes in practical dentistry. As bonding agents continue to evolve rapidly, it becomes increasingly important to identify different types of adhesives, their purposes, and the differing techniques required for their efficient placement
Dental management during stem cell transplantation
Authors: Burke Suzanne , Kwasnicki Andrew J , Macpherson J Avril
Published: May 2014

Stem cell transplantation, or bone marrow transplant, is used to treat haematological disease including blood cancers. This therapy has oral health implications for patients, who need thorough preoperative dental assessment and appropriate treatment
Dental management of the head and neck cancer patient
Authors: Kwasnicki Andrew J , Burke Suzanne , Macpherson J Avril
Published: May 2014

The aim of this paper is to discuss cancer of the head and neck, the causes, and potential treatment options and their side effects. It also discusses the role of the specialist dental team in assessment and dental treatment prior to cancer treatment and dental management during cancer treatment
Laser surgery of the equine upper respiratory tract
Authors: Barakzai Safia
Published: May 2014

Safia Barakzai BVSc MSc DETS Dipl ECVS Associate ECDVI MRCVS of the University of Edinburgh, Roslin, Midlothian, discusses this very specialised technique
Gut Feelings
Authors: Stephens Jenni , Dentith Louise
Published: May 2014

Jenni Stephens (REVN) and Louise Dentith (MSc), Lecturers in Equine Studies at Moulton College examine the causes of colic and its treatment
Horse ID: Information breakdown?
Authors: Gau Ally
Published: May 2014

Ally Gau investigates the impact of closing the National Equine Database
Are bone fractures avoidable?
Authors: Pollock Patrick
Published: May 2014

In the first of series focusing on fractures in racehorses Patrick Pollock European and RCVS recognised specialist in equine surgery, discusses bone modelling and remodelling
Tested on humans…
Authors: Hollis Georgie
Published: May 2014

Georgie Hollis, of the Veterinary Wound Library, investigates the application of medical treatments in veterinary wound management
Elmer
Authors: McKee David
Published: May 2014

Have you ever met a patchwork elephant? Tracy Hilton, a nursery teacher in Sale, near Manchester, has a few tips to make the most of this wonderful book, and to have tons of fun along the way.
Looking up in the sky
Authors: Barber Jenny
Published: May 2014

Here is a special project that will have you and your class look up in the air for inspiration. You will make some interesting discoveries along the way, promises Jenny Barber.
Child Health Cot Death
Authors: Walker Robert
Published: May 2014

This month, Robert Walker looks at the inexplicable phenomenon that is cot death and the impact it has on families and communities.
Open your doors? We've been doing it for a decade
Authors: Scott Wendy
Published: May 2014

A school in Huddersfield has been opening its doors to parents and the community for over 10 years, reports Wendy Scott.
Togetherness and partnership = empowerment
Authors: Langston Ann
Published: May 2014

Many practitioners feel less than confident about working with parents, an essential aspect of work with young children. By Ann Langston.
The golden rule is that the family must come first
Authors: Wall Kate
Published: May 2014

Considerable time is spent in planning for children with special needs but do we consider the needs of their families? By Kate Wall.
Building proper partnerships with all parents
Authors: Brooker Liz
Published: May 2014

Early years educators work with families, not just children; and talking to parents (and learning from them) is a vital part of the job. By Liz Brooker.
Schools are ideal places for literacy courses
Authors: Holmes Andria
Published: May 2014

Never presume parents understand everything that is communicated to them. Get help in dealing with adult illiteracy, says Andria Holmes.
Open access that leads to more child initiated activities
Authors: Bromley Helen
Published: May 2014

Helen Bromley shifts the focus of her outdoor series to look at issues surrounding the effective and continuous provision of an outdoor area.
Petal POWER
Authors: Campbell Sharon
Published: May 2014

Children love the sight and smell of flowers, and with flower shops full of colour all year round, Sharon Campbell explores ways for children to enjoy flower shop role-play.
Early years pioneers
Authors: Martin Estelle
Published: May 2014

In this month's article, Estelle Martin takes a closer look at Jean Piaget and Lev Vygotsky, two of the most influential figures in the history of early childhood education whose influence is still felt today.
Other cultures
Authors: Chapman Ailsa
Published: May 2014

Most settings will have children from a wide variety of countries, which means there will be plenty of opportunities to explore the similarities between people from different parts of the world.
Birthday party role-play
Authors: Barber Jenny
Published: May 2014

Following children's leads and exploring their interests is important in the early years, and what better opportunity to engage in enjoyable experiences than by setting up a birthday party role-play area.
The language of mind
Authors: Pound Linda
Published: May 2014

In the last of her series, Linda Pound examines psychologist Steven Pinker's view of the nature/nurture debate, which although dividing opinion among academics, does have implications for the early years.
Real-life experiences
Authors: Myatt Petra
Published: May 2014

As a recently qualified early years professional, I am always looking at interesting ways to extend children's learning, especially those that are rooted in real-life experiences outside of the nursery.
Special educational needs: Issues and challenges
Authors: Wall Kate
Published: May 2014

Despite the long-term drive to increase levels of inclusive provision in this country, there are still many signifi cant issues aff ecting the quality of early years care and education for children with special needs.
Coping with grief and loss
Authors: Smythe Amy
Published: May 2014

Young children will experience loss or separation of some sort while in our care, whether from moving home, the death of a pet, or the loss a close family member, and we must know how to support them.
Senses on the shore line
Authors: Whitnell Jackie , Wrightson Danielle
Published: May 2014

The effects of taking children outdoors and into different and varied environments are well known, especially given the rise of forest schools, so as an island nation why not make use of our beaches?
Creating shadow plays
Authors: Finlayson Keri
Published: May 2014

The first article in a short series exploring the use of puppets in the early years, here we explore a traditional form of puppetry that brings into play other concepts, such as light, dark and shadow.
Michael Rosen: Why SATs are bad for literature
Authors: Rosen Michael
Published: May 2014

In the first of two articles about literacy and creativity, much-loved children's poet Michael Rosen speaks frankly, and exclusively to Five to Eleven, about his views on literacy and education.
Once upon a time …
Authors: Dawson Georgina
Published: May 2014

Georgina Dawson, creator of Play-talk-think-write boxes, talks about the importance of reading aloud to children to help them to understand story elements
Knowing about other cultures from the start
Authors: Paice Chris
Published: May 2014

Year 1/2 lesson on helping children gain better knowledge and understanding of the world using ICT
Health and fitness first
Authors: Wilkin Linda
Published: May 2014

Linda Wilkin reports on the initiatives that are fighting back at statistics predicting health problems for a new generation
Developing self control
Authors: Louis Sara
Published: May 2014

Why do children differ so much in their ability to control their emotions? Can teachers do anything to foster this skill?
Reviews
Authors: Rhodes Liz
Published: May 2014

Colours and Patterns Pictures, Poems and Feel Good Friends Percussion 2
April showers!
Authors: Hammond Paula
Published: May 2014

This season is traditionally associated with changeable weather, as spring begins to turns into summer
Whatever happened to childhood?
Authors: Rhodes Liz
Published: May 2014

Liz Rhodes discusses the pressures brought to children in today's competitive atmosphere
Understanding light
Authors: Hammond Paula
Published: May 2014

January 4 (1643) is the birthday of one of Britain′s most influential scientists, Sir Isaac Newton.
Walk the plank!
Authors: Keeling Anne
Published: May 2014

Treasure is one of the thematic units of work from the International Primary Curriculum (IPC), a thematic, cross-curricular, engaging curriculum for children, yet one that provides direct links to National Curriculum guidelines, and focuses significantly on skill-based learning..
More men please!
Authors: Kirby Dahlian
Published: May 2014

Last year there were a lot of articles in the press about the shortage of male teachers, especially for younger children. Dahlian Kirby discusses this issue
Getting tougher on crime
Authors: Mill Patsy
Published: May 2014

Patsy Mill asks what we should do about children who we know are likely to become criminals in the future
Designing a colorectal nurse-led clinic: the Merthyr protocol
Authors: Lewis Maria , Joseph Anton , Shah Parin , Kulkarni Nikhil , Lipp Allyson , Haray P N
Published: May 2014

In July 2001, a phased training programme was developed by the colorectal team at the Prince Charles Hospital, Merthyr Tydfil, Wales, to enable a specialist nurse to run independent colorectal clinics. Continuous audit and assessment was undertaken during the training period. The colorectal nurse specialist (CNS) progressed from shadowing the consultant to running her own independent clinics. To date she has seen 1467 patients as part of the training programme. A patient satisfaction survey conducted in 2004 found 95% acceptance of the nurse-led service. No significant colorectal pathology has been missed by the CNS during this period and no colorectal cancer patient has been lost to follow-up. The clinics have helped to reduce waiting times for both new referrals and patients attending for follow-up. The CNS is a valuable resource, providing support for colorectal services without compromising the quality of care. The authors′ experience demonstrates conclusively that this protocol can be used successfully to redesign a nurse′s role to provide a safe and effective colorectal service in the outpatients department.
Lumps and bumps in the upper gastrointestinal tract
Authors: Doig Laura
Published: May 2014

Over the last decade, endoscopic ultrasound (EUS) has proven to be the most significant advance in imaging of the upper gastrointestinal (GI) tract wall and surrounding organs, including the pancreas, common bile duct and gall bladder. EUS can provide unique information essential to the diagnosis of both benign and malignant disease that is often otherwise obtainable only by surgical information. More importantly, EUS is able to provide detailed imaging of the five layers of the GI wall and its ability to characterise subepithelial lesions is unparalleled (Shen et al, 2002).
Live donor liver transplantation: ensuring donor safety
Authors: Clayton Michelle
Published: May 2014

The first NHS adult−to−adult live liver donation and subsequent transplant took place in June 2007. This treatment modality has been pursued due to falling numbers of organ donors. Live donor safety is of utmost importance, as up to 60% of liver tissue will be removed. This article discusses the creation of a protocol by the Leeds Liver Unit to manage the donor assessment phase which is influenced by recent legislation. Live liver donation is an encroachment on the integrity of a healthy organ; therefore, the identification of physical and psychological risk factors is paramount to ensure donor wellbeing and safety.
Coping mechanisms in women living with pelvic floor dysfunction
Authors: Porrett Theresa , Carol L Cox s Carol
Published: May 2014

Purpose: Pelvic floor dysfunction (PFD) encompasses symptoms that include urinary and faecal incontinence, obstructed defaecation and pelvic organ prolapse. It impacts on the quality of life of women, and is associated with stigma, embarrassment, and a delay in seeking help. Nurses often see women in clinics who have both colorectal and urinary symptoms, many of whom have delayed seeking help. Aim: To understand the coping mechanisms women develop and the triggers which prompt seeking help. Methodology: Micro−ethnography focusing on the emic (personal worldview) perspective of women with PFD. Findings: Ten themes relating to coping and help seeking have emerged. These are: knowledge; health care beliefs; coping mechanisms; perception of severity of the problem; role obligations; emotions; locus of control; trigger events; financial implications; and personality. Subsequently, specific tools for use in exploring coping and help seeking have been developed.
A guide to providing culturally appropriate care
Authors: Black Pat
Published: May 2014

The delivery of health care does not happen in a vacuum. What health care professionals demonstrate daily is that treating illness is not as simple as making a diagnosis and prescribing a cure. Health is very much part of a person′s life, involving upbringing, culture and faith. One of today′s challenges is to bring to a multi−ethnic society a high quality of care that meets the appropriate needs of the patient (Hancock, 2003). In a multicultural, multi−faith society, it is essential that care is offered in way that respects and accommodates everyone′s cultural and religious needs (Greengross, 2003).
A step−by-step guide to performing a complete abdominal examination
Authors: Cox Carol , Steggall Martin
Published: May 2014

This clinical skills series is designed for the nursing professional as a basic overview on key clinical skills necessary for patient care, clearly presenting common clinical procedures and their rationale, together with the essential background theory. In this first article in the series, Carol Cox and Martin Steggall describe the process associated with abdominal assessment. It focuses on a systematic approach and highlights areas in which gastrointestinal nurses may enhance their knowledge and practice.
Understanding the complexities of the clinical nurse specialist: A focus on stoma siting
Authors: Rust Julie
Published: May 2014

The concept of the ′specialist nurse′ is not new, but has changed significantly since its conception in the format we are familiar with today. There are many different areas of nursing today in which clinical nurse specialists are employed and although a definitive definition of the role is yet to be decided, there is a general consensus that this multidimensional role encompasses several defined areas, including education, research, management, clinical and consultant roles. The specialist role of the stoma care nurse encompasses all aspects of the specialist role as discussed; however, to demonstrate the complexities in greater detail, this article will examine the role of the stoma care nurse and stoma siting. Stoma formation impacts significantly on the psychological, emotional and physical wellbeing of the patient. Therefore, the correct positioning of the stoma should be a priority for any healthcare professional caring for the individual. A poorly-positioned stoma can cause both physical and psychological problems for the patient. Alternatively, a well-sited stoma can improve quality of life for the ostomate, thereby helping the individual accept the stoma.
Development of an integrated care pathway for elective colorectal surgery
Authors: Goode Catherine , Harley Jacqueline
Published: May 2014

With the aim to promote a seamless journey of patient care from diagnosis through to aftercare, coupled with improving quality and possibly reducing the length of hospital stay, an integrated care pathway for patients undergoing colorectal surgery incorporating the enhanced recovery program (ERP) was developed by the colorectal team in Jersey, Channel Islands. Applying the principles of the ERP, the pathway document encompasses six key stages: referral; assessment; surgery; postoperative management; aftercare; and follow up. Developed by a clinical team responsible for its application in practice, the pathway′s formation followed a systematic process that included: establishment of aim, objectives and scope; application of evidence-based practice; care sequence mapping; staff training; piloting; ratification and rollout.
Evaluating gravity versus pump irrigation for bowel dysfunction
Authors: Crawshaw Alison , Marshall Jill , Bartolo David CC , Duthie Graeme S , Fawcett Tonks N , Smith Graeme , Williams Claire
Published: May 2014

Rectal irrigation as a method of management for patients suffering bowel dysfunction is relatively new in the UK (Gardiner et al, 2003). However, patients in the Lothian region have been offered rectal irrigation by means of gravity device since 1998, while patients in the Hull and East Yorkshire area have been able to receive electric pump irrigation since 2001. A two-centre crossover trial was designed to capture quantitative data and a free-report narrative questionnaire was used to collect qualitative data to investigate the comparative efficacy and acceptability of the two methods, in terms of bowel function and quality of life measure.
Facing the future: A continuing role for NEs through advanced practice
Authors: Chapman Warren
Published: May 2014

Nurse endoscopists have the potential to practise at an advanced level providing they achieve appropriate levels of education and competencies. While other non-medical endoscopists exist, these technicians cannot operate at the same level. Additionally, patient satisfaction has been found to be greater with nurse endoscopists than medical endoscopists (Williams et al, 2009), which may reflect their nursing background. However, the cost-effectiveness and therefore the appropriateness of the role of nurse endoscopists has been questioned, and there is ambiguity over the minimum academic level required to practise. Warren Chapman argues that in order to overcome these obstacles, nurse endoscopists need to ensure they are educated to a minimum of degree level and meet competencies of advanced practice in order to offer a complete service for patients.
Guidelines for treating stoma granulomas at the mucocutaneous junction
Authors: Dukes Suzie , Lowther Claire , Martin Tessa , Osborne Debbie
Published: May 2014

A working party of stoma nurses from the Wessex stoma care nurses forum explored the management of stomal granulomas at the mucocutaneous junction and found that there were no clear guidelines and a diversity of management regimens. Through gathering information, collating the evidence and rationale, and formulating a flowchart outlining the treatment recommendations, the Wessex group has produced guidelines for standardizing treatment. In this article, appropriate assessment of the patient is outlined, as well as three practical treatment plans in seeking to manage problematic granulomas. These recommendations have been accredited by the Royal College of Nursing and a poster will be rolled out nationally.
Intestinal transplantation in children: Promoting quality of life as well as survival
Authors: James C , Gupte G L
Published: May 2014

Once considered to be an experimental treatment for children with irreversible intestinal failure, intestinal transplantation has progressed into a well-established and life-saving procedure. In the last decade major advances in surgical techniques, immunosuppressive medications, infection prevention and treatment, optimum patient selection and timely placement on the transplant waiting list have contributed to significantly improved outcomes. The emphasis in managing these patients is now on long-term survival and quality of life. The aim of this article is to explore the latest innovations in intestinal transplantation.
High impact actions for stoma care
Authors: Porrett Terri , Frost Sue , Elcoat DBE Catherine
Published: May 2014

Stoma care nurses from across the UK have contributed to the development of High Impact Actions for Stoma Care, to support the nationally identified high impact actions and to determine what other actions may be specific to stoma care. Dr Terri Porrett, Sue Frost and Dame Catherine Elcoat DBE explain.
Barriers to uptake of bowel screening and interventions in North East London
Authors: Meeran Mumtaz , Smith Caroline
Published: May 2014

There is a complex interaction of various factors that determine whether someone will participate in the bowel cancer screening programme. These include socio-economic factors, demographic factors, the presence of any symptoms and the acceptability of the faecal occult blood test to the participants. Mumtaz Meeran and Caroline Smith outline the barriers to uptake and interventions to increase involvement in the screening programme, discussing the results of focus groups to further understand motivations and avoidance.
Body image perception, the stoma peristomal skin condition
Authors: Nichols Thomas R , Riemer Michael
Published: May 2014

The perception of body image can change according to a number of different variables including age, weight, height and self-esteem. It is widely accepted that physical changes to the body lead to a change in body image. Any surgery resulting in an altered body appearance, such as ostomy surgery, may alter perceptions or amplify negative perceptions. In this article, Thomas Nichols and Michael Riemer discuss the effect of stoma surgery and peristomal skin on body image perception.
Staffing the endoscopy department: what is the appropriate skill mix?
Authors: Hutson Pauline
Published: May 2014

Endoscopy procedures vary in their complexity from diagnostic tests in a healthy population to complex procedures in patients with acute and long-term disease. The majority of endoscopy procedures are straightforward but when complications or emergencies arise the need for an efficient, coordinated and competent team is essential to ensure safe patient management. In this article, Pauline Hutson discusses the appropriate nurse skill mix required to adequately and safely staff endoscopy units, and the underlying skill, knowledge and organization required to reduce patient risk.
Nursing research careers in the NHS
Authors: Dainty Andrew , Cooper Joanne
Published: May 2014

Nurses play a pivotal role in research within the NHS. In this article, Andrew Dainty and Joanne Cooper aim to discuss the opportunities for nurses to become involved in the research process and Andrew Dainty also shares his experiences in applying for a prestigious award to undertake clinical academic training. It is hoped that this article will inspire nurses who have considered becoming involved in clinical research to begin to make enquiries into the research activity within their clinical environment. Clinical academic training is discussed as a possible career option for nurses who wish to embark on a research career.
Transference and countertransference in anorexia nervosa care
Authors: Swatton Anna
Published: May 2014

Anorexia nervosa is an eating disorder characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight. Gastrointestinal symptoms that can manifest due to a decrease in food intake include constipation and complications due to laxative abuse. The focus of biofeedback therapy is to holistically assess the patient's symptoms, provide education and return bowel and muscle control to normality. In this article, Anna Swatton discusses the complexities of caring for a patient with anorexia nervosa in a gastrointestinal care setting, by reflecting on a case study. The dynamics and the importance of the therapeutic relationship and its importance of this in ensuring optimal patient care will be discussed.
The implications of stoma reversal on patient outcome
Authors: Black Pat
Published: May 2014

The closure of a temporary stoma, whether a colostomy or ileostomy, may be eagerly awaited by the stoma patient and encouraged by the surgeon. However, the procedure is not without risk, complications of stoma reversal may include disruptive bowel changes, wound infection, sepsis and death. The decision to restore intestinal continuity is often underestimated, and the reversal of a colostomy after a Hartmann's procedure implies a high mortality and low percentage of restoration of intestinal continuity. In this article, Pat Black assesses the effects of colostomy and ileostomy reversal on patient outcome.
Endoscopic electrosurgery an overview
Authors: King Charlotte
Published: May 2014

Electrosurgery is an invaluable tool for even the most basic therapeutic endoscopic procedures including polypectomy, sphincterotomy, tissue ablation and the maintenance of haemostasis. It uses the production of heat by the flow of high frequency alternating electrical current through living tissue to produce either a cutting or coagulating effect as is influenced by current, voltage, circuit and impedance. In this article, Charlotte King provides an overview of electrosurgery, its uses, and risk management and safety issues.
Paediatric stoma care: surgery and management
Authors: Slater Rebecca
Published: May 2014

Children undergo the formation of a stoma for many reasons and in some cases it can be a life-saving operation. The role of a stoma care nurse caring for babies and children that require a stoma is to teach and support the parents and families how to care for their child’s stoma. Not all hospitals are fortunate enough to have a stoma care nurse specifically trained in the management of paediatric stoma care and so the help and advice of such a speciality is essential in caring for this group of patients safely and effectively. In this article, Rebecca Slater explores the conditions that require the formation of a stoma within a paediatric setting and the care and support that they and their families may need in order to manage the stoma. Emphasis has been placed on the Paediatric Stoma Nursing Group in order to build awareness and collaboration between the two groups within this speciality.
GIN—the tonic for endoscopy nurse education?
Authors: Tobin Sarah
Published: May 2014

In this article, Sarah Tobin details the development of a national endoscopy education and training programme for nurses, to highlight the evolution of the course and to explain the current context of the programme. A personal perspective on the importance of continuing professional development and the challenges faced by nurses to take control of their own education is also presented.
Caring for the patient with a stoma and dementia
Authors: Black Pat
Published: May 2014

Dementia is a generic term indicating the loss of intellectual functions including memory, significant deterioration in the ability to carry out day-to-day activities, and often, changes in social behaviour (Scottish Intercollegiate Guidelines Network (SIGN), 2006). It is a complex condition which can be linked with a number of medical difficulties, including urinary and faecal incontinence. For the patient with dementia and a stoma, management techniques need to be considered from the point of view of the patient and the carer. It is important for people working in health and social care to have some understanding of the signs of dementia so that they are able to adjust their care accordingly (Department of Health, 2011). In this article, Pat Black outlines the different types of dementia and discusses stoma care management for people with dementia.