bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative efficacy of cervical retraction exercises (McKenzie) with and without using pressure biofeedback in cervical spondylosis
Authors: Wani Surendra , Raka Neha , Jethwa Juhi , Mohammed Rafi
Published: May 2014

Aim:

To compare the effectiveness of cervical retraction exercises (McKenzie) with or without using pressure biofeedback in reducing pain and disability among patients with cervical spondylosis.

Methods:

Thirty participants of both genders and aged between 30 and 70 years who were medically diagnosed with cervical spondylosis were included and allocated by randomised sampling into two study groups. Group A were given cervical retraction exercises and Group B were given cervical retraction exercises and instructed to use a pressure biofeedback unit during these exercises. All of the participants in Group A and B were also given moist packs. The outcome measures used both pre- and post-intervention were: the Numerical Pain Rating Scale (NPRS), which was used to assess for pain, and the Northwick Park Pain Questionnaire (NPQ), which was used to assess for disability. The demographic data collected in the study were the age and symptom duration.

Results:

The t tests of the post-interventional NPRS scores (P=0.0001*; t=4.5683), and post-intervention NPQ scores (P=0.0001*; t=4.945) showed a statistically significant difference between Group A and Group B.

Conclusion:

The findings of the study indicates that there was a significant reduction in neck pain and disability in both the groups. However, cervical retraction exercises using pressure biofeedback proved to be better than cervical retraction exercises alone.
Insomnia in chronic lower back pain: Non-pharmacological physiotherapy interventions
Authors: Nalajala Narender , Walls Kaye , Hili Ethel
Published: May 2014

Background:

Managing chronic lower back pain (CLBP) is a challenging issue for physiotherapists working in musculoskeletal clinics because of its complex bio-psychosocial nature. Sleep disturbance is one of the common complaints in CLBP patients.

Aims:

To bring an awareness and understanding of: the prevalence of sleep disturbance in CLBP; the effects of anxiety and stress on sleep; the effects of poor sleep on pain; and non-pharmacological management of insomnia

Methods:

A relevant literature search was conducted using the terms ‘back pain and sleep disturbance’, ‘back pain and insomnia’, ‘insomnia and stress, anxiety’, ‘sleep and inflammation’ and ‘non-pharmacological treatment of insomnia’. Relevant articles were analysed to understand the prevalence, effects of insomnia on CLBP and the non-pharmacological treatments of insomnia.

Results:

There is evidence for sleep disturbance in CLBP patients. Pain, anxiety, depression and stress are associated not only with CLBP but also with insomnia. Non-pharmacological treatments like sleep hygiene, cognitive behavioural therapy (CBT), exercise and stimulus control are effective in improving sleep quality.

Conclusion:

Understanding the nature and extent of sleep disturbance in CLBP and the non-pharmacological treatments of insomnia should be an integral part of CLBP management, factors which are often neglected and poorly understood by physiotherapists.
Supporting supplementary prescribing
Authors: Belton Julie
Published: May 2014

A computerised template for clinical management plans helps cut the stress out of supplementary prescribing.
Roseola infantum
Authors: Watkins Jean
Published: May 2014

A toddler with a rash may alarm parents, but roseola infantum is easily managed.
Tackling MRSA in the community
Authors: J Fairclough Sarah
Published: May 2014

Healthcare associated infections are not restricted to hospitals.
Tackling a hidden epidemic
Authors: Price David
Published: May 2014

Allergic disease is on the rise and primary care must take a lead role in service provision.
More than the sum of its parts
Authors: Applebee Kathie
Published: May 2014

Unified nursing needs careful organisation, but proves the benefits of working together, says Kathie Applebee
Treating complex cases of COPD
Authors: Booker Rachel
Published: May 2014

Co-morbid conditions make managing COPD difficult in many patients. Rachel Booker outlines the prescribing options for nurses
Diagnosis and care of Bell's palsy
Authors: Watkins Jean
Published: May 2014

Bell's palsy has a sudden onset, is caused by herpes viruses and those affected suffer facial weakness.
In-flight medical incidents
Authors: Kahn Farrol
Published: May 2014

Air travellers face certain health risks. Farrol Kahn outlines the research and recommendations for patients intending to fly
Spinal manipulation therapies
Authors: Ernst Edzard
Published: May 2014

Both chiropractic and osteopathy involve spinal manipulation. Professor Edzard Ernst scrutinises the evidence for these interventions
Recognising alcohol abuse
Authors: Jarvis Sarah
Published: May 2014

A few simple questions can help identify which of your patients are dependent on alcohol
Using creative writing in palliative care
Authors: Higgins Bernadette
Published: May 2014

Creative writing classes ease patients’ stress and boost their self-esteem, writes Bernadette Higgins.
Managing obesity in men
Authors: Grant Jane
Published: May 2014

Men can be unaware that they are overweight. Jane Grant explains her own practical approach to tackling weight loss specifically in men.
Developments in osteoporosis
Authors: Morris David
Published: May 2014

Primary and secondary prevention of osteoporosis in accordance with recently published guidance is outlined by Dr David Morris.
Piloting integrated care
Authors: Freeman Bryony
Published: May 2014

An integrated health organisation is showing how the government pilots could work.
Hyperprolactinaemia
Authors: Newson Louise
Published: May 2014

Raised prolactin levels should be investigated and treated.
Psoriatic arthritis
Authors: Watkins Jean
Published: May 2014

Overall key points Psoriatic arthritis is an inflammatory arthritis associated with psoriasis. There is potential throughout life for progressive and permanent joint damage. It usually presents with asymmetrical pain, swelling and tenderness in the small, distal joints of hands and feet. Early assessment and treatment advice by a rheumatologist may reduce long-term joint damage
Diabetes and learning disabilities
Authors: Phillips Anne
Published: May 2014

Diabetes is more common in people with learning disabilities, and these patients may find it more difficult to discuss their needs.
Heavy menstrual bleeding
Authors: Kochhar Suneeta
Published: May 2014

Presentations of menorrhagia can be subjective and require thorough assessment and evaluation.
Chlamydia screening in primary care
Authors: Hill Barry
Published: May 2014

Recent figures revealed an increase in chlamydia diagnoses. Barry Hill examines the role the National Chlamydia Screening Programme can play in this context
Treating bacterial vaginosis
Authors: Powell Karen
Published: May 2014

Bacterial vaginosis is experienced by 10 per cent of women and is a common cause of acute vaginitis.
Supraventricular tachycardia
Authors: Meredith Tara
Published: May 2014

Supraventricular tachycardia (SVT) describes a regular narrow complex tachycardia (NCT) (usually > 100bpm) with a QRS duration of 120ms or less. 1 SVT is a relatively common arrhythmia affecting approximately 2-3 per cent of the population; it is usually paroxysmal and rarely life-threatening but can impact on quality of life due to troublesome symptoms. 2
The benefits of home support in encouraging breastfeeding
Authors: Duxbury Rachel
Published: May 2014

Breastfeeding support in the community can enable women to sustain breastfeeding for longer, benefiting babies.

Breastfeeding is not always as easy as it looks. In some cases, it takes considerable determination, persiste
The diagnosis and treatment of pleurisy in general practice
Authors: Greener Mark
Published: May 2014

Identifying and treating the underlying cause of pleurisy may be life-saving, writes Dr Suneeta Kochhar
Small steps, big changes
Authors: Hill James
Published: May 2014

LIFESTYLE

Obesity continues to be a public health challenge with long-term consequences. James Hill suggests an alternative way of thinking about weight
Mental health legislation: an era of change in paramedic clinical practice and responsibility
Authors: Parsons Vaughan , O'Brien Louise , O'Meara Peter
Published: May 2014

For emergency health professionals, the response to a mental health emergency in the community is often brief in nature and centred on quickly ascertaining whether a patient is psychiatrically or physically unwell. For paramedics, mental health emergencies are often challenging because of the ambiguous nature of clinical presentations, lack of collaborative information such as a patient's medical history and back up assistance. Mental health emergencies require paramedics to possess advanced interpersonal skills and patient assessment competencies. With the introduction of new emergency powers across Australian state and territory-based mental health legislation, the roles and responsibilities of paramedics across some jurisdictions has changed significantly. In response to these changes, a number of ambulance services have introduced specific mental health training programmes in an attempt to prepare their workforce to meet and fulfil their legislative responsibilities. In spite of this, the role of paramedics in the care and management of the mentally ill has attracted limited attention in the research literature. This article examines the role of the paramedic with respect to mental illness, what is known about paramedics' clinical decision-making practices, and the opportunities for future development of their scope of practice. It identifies the need for further research to explore the clinical decision-making processes are used by paramedics when fulfilling their mental health legislative responsibilities.
Is the Australian paramedic discipline a profession? A national perspective
Authors: Williams Brett , Onsman Andrys , Brown Ted
Published: May 2014

Background

Over the past century the Australian paramedic discipline has gone through a dramatic evolution; moving from its origins of an ambulance driver to its current practitioner role as an integral member of the Australian health care system. However, at present the Australian paramedic discipline is not considered a full profession by the national or state governments. This begs the further question, how does the paramedic discipline within Australia view itself?

Objectives

This paper has two objectives: 1) To examine whether or not the Australian paramedic membership views itself as a profession, and 2) if it does not regard itself as such, whether the paramedic community wants to be considered a full profession within Australia.

Methods

3800 questionnaires were posted to all Australian College of Ambulance Professionals (ACAP) members around Australia. An investigation of attitudes towards professionalisation were investigated using an 8-item paper-based self-report questionnaire using a 5-point Likert scale (1=Strongly Disagree to 5=strongly agree).

Findings

A total of 872 paramedics (23 % response rate) returned completed questionnaires. The responses indicated that, broadly speaking, the Australian paramedic membership does not consider itself a recognised profession, furthermore, the Australian membership indicated a desire for paramedics to be recognised as a profession.

Conclusions

Given that first, the paramedic discipline does not presently view itself as a full profession and second, the paramedic discipline wants to become recognised as a profession. The study identified a set of underpinnings of professional paramedic practice; including professional autonomy, national accreditation for paramedic education programmes, and the development of a unique body of knowledge.
Poor mental health services shame us
Authors: Cooper Michael
Published: May 2014

The mental health of young people is a complex issue, but there is some indication of a rise in mental health problems in this group. It is difficult to be sure whether this rise is due to a greater awareness of the issues generally or to a genuine increase in distress among young people themselves. Either way, it is an issue that increasingly demands the attention of healthcare providers?
Delivering a healthy future
Authors: Farrelly Rory
Published: May 2014

Delivering a Healthy Future: The Action Framework for Children and Young People’s Health in Scotland (Scottish Executive, 2007) was developed as part of the Delivering for Health agenda in Scotland and draws together the major areas of policy and guidance that impact on the delivery of health services for children and young people.
Ascertaining GP demand for a full-time paediatric emergency assessment unit
Authors: Aitken Penny , Glasper Edward Alan , Wiltshire Maureen , John Patricia , Abay June
Published: May 2014

Changes in the general practitioner (GP) contract have led to the development of a variety of models for managing children who become sick outside of GP surgery hours. One such model is the hospital-based 24-hour paediatric emergency assessment unit (PEAU). This study sought to assess the demand for such a service in one English regional health authority.

The opinions of general practitioners (GPs) regarding the service were sought via a fax survey, and a retrospective analysis of out-of-hour admissions staying less than 24 hours, over two discrete three-month periods. Differences in GP referral outcomes were also examined.

GPs using the current PEAU (N=431) were invited to participate. GP’s responses, and analysis of PEAU out-of-hours throughput and admission trajectories were obtained. Results indicate that 83.9% of respondent GPs strongly agreed or agreed that the unit should provide a 24-hour PEAU service. 987 sick children were admitted to hospital out of PEAU opening hours, of which 404 had a stay of less than 24 hours. There was widespread approval by GPs to implement a 24-hour PEAU service, however, analysis of the hospital data showed that there were currently insufficient out-of-hours admissions to warrant changes in service delivery.
Children’s rights in action
Authors: Richardson Jim
Published: May 2014

For children’s and young people’s (CYP) nurses in Wales, the last year has been typically fluid, dynamic—and in many respects, rewarding. Six years after the institution of the National Assembly for Wales (and with it a distinctive Welsh government), health and social policy with regard to children and young people is increasingly distinctive and designed specifically to the particular needs of Welsh society. The importance of Welsh as the indigenous language in this country is continually underscored and services in Welsh are improving all the time. There is still room for enhancement in this respect in sectors such as health professional education and very vigorous activity is seeing us on the way to achieving this. A lot of work is being done in sectors such as health and social care to raise awareness of the importance of carrying out research that includes Welsh speakers in their first tongue. This work has had the happy effect of raising awareness of how important language is in the health services for speakers of other community languages too. This constitutes an important on-going challenge for CYP nurses.
Child carers: the forgotten workforce
Authors: Alan Glasper Edward
Published: May 2014

Following the untimely death of a young carer earlier this year (Bennett, 2007) the plight of child carers has been the subject of much debate in the press recently, although concern about these vulnerable children has been expressed by health and social care professionals for many years. Over a decade ago Keith and Morris (1995) were warning that the rights of children who acted as primary carers were being undermined and that some children’s very own childhood was being blighted in caring for dependent siblings or relatives’. The scale of the problem is both hidden and underestimated. Doran et al (2003), in analyzing the data from the 2003 census, confirmed that the previous estimates of young carers which had estimated that there were between 10 000 and 50 000 were taken too lightly and that the real figure was closer to 114 000 with recent press reports putting it as high as 175 000 or more. Worryingly this same census data set showed that 9 000 children were providing at least 50 hours of care per week.
Review of NICE guideline 47: assessment and management of feverish illness in young children
Authors: Brett Wendy
Published: May 2014

This article considers the recently published guidance from the UK’s National Institute for Health and Clinical Excellence (NICE) on the assessment and management of fever in children under 5years old. It highlights the key areas that will help reduce inconsistency in current clinical practice.
Every child matters, but what matters to them? Using teenagers’ views to shape health services
Authors: Wicke Dorothy , Coppin Richard , Doorbar Pat , May Andrée Le
Published: May 2014

UK policy explicitly values children’s health, safety, achievement, contribution and economic wellbeing and emphasizes the need to ensure that ‘every child matters’ when services are designed and implemented (Department for Education and Skills, 2003). In order to find out how a new, school-based, ‘confidential health service’ might best address their needs we consulted 106 teenage pupils from two comprehensive secondary schools each providing education for children/young people from 11–16 years, and a pupil referral unit (PRU). The PRU provided education to a more disadvantaged group of students excluded, for both academic and behavioural reasons, from main stream school. The study design incorporated individual and group exercises and discussion. Qualitative data were generated and analysed thematically. Results were compared with 241 responses from a concurrent questionnaire survey, of similar content, of all pupils in one of the schools.

The results suggest that the establishment of a confidential school-based health service is feasible and would be supported by its intended users. Its priority should be the provision of advice and support, rather than ‘treatments’, and its success would be dependent on a continuing guarantee of confidentiality in its dealings with pupils. The service worker would not necessarily require formal qualifications but should demonstrate strong listening and counselling skills.

The extent to which young people were happy to participate in this project not only suggests the appropriateness of the methods used, but also that the pupils would be able and willing to continue to shape and support the new service. Three teenagers with recent school experience guided the research planning team to ensure a fit between the design of the study and the realities of fieldwork.
An investigation of the terminology used for children with life-limiting conditions
Authors: Nicholl Honor
Published: May 2014

The purpose of this quantitative study was to investigate the terminology that Irish nurses used when referring to children with life-limiting conditions. The study was part of the preliminary work that was undertaken as part of a Doctoral study that explored mothers’ experiences of caring for children with complex needs. Given the sensitivity that can surround the term ‘life-limited’, this study was undertaken to identify the terminology that nurses use in their practice.

Data were collected from a sample of 46 registered nurses using a specifically-designed, structured questionnaire administered by telephone interview. The questionnaire was based on the definitions of life-limited outlined by the Association for Children with Life-Threatening or Terminal Conditions and their Families (ACT) and the Royal College of Paediatrics and Child Health, and the four broad groups of life-limited children they describe.

The results indicate that a wide range of terms are used by nurses for children with life-limiting conditions. Terms used refer to the child’s diagnosis, the chronic nature of the illness and the limitations that the illness causes. The study findings suggest that the terminologies used differ despite a common available definition that, because of its diagnostic focus, may not accurately reflect the complex nature of these children’s nursing and care needs.
The contribution of specialist nurses to the management of cystic fibrosis in Ireland
Authors: Savage Eileen
Published: May 2014

The management of cystic fibrosis is complex and involves multiple health professionals. In European standards of care for delivering the best possible outcomes for patients and their families, specialist nurses are identified as integral to the multidisciplinary management of cystic fibrosis (Kerem et al, 2005). However, little is known about the contributions that specialist nurses make to the management of cystic fibrosis from the perspectives of children and their parents. This paper examines children’s and parents’ perspectives on how specialist nurses help them manage cystic fibrosis. The data are drawn from a larger study involving 32 Irish children (aged 6–14 years) and their parents. Interviews were the main method of data collection and a method of constant comparison was used to analyse data. Specialist nurses were described as making a particular contribution to helping children and parents manage challenges and difficulties that arose in their daily lives. Specifically, specialist nurses helped by being accessible, forming personal relationships, having ‘expert’ knowledge and attending to emotional and social care of children and their parents. However, the organizational context of clinic consultations placed limitations on specialist nurses addressing concerns of relevance to children’s and parents’ day-to-day lives. Implications for practice in addressing these limitations and for further developing the role of specialist nurses especially during clinic consultations are considered. Areas for further research on the role of specialist nurses are identified.
Paediatrics and child health
Authors: Richardson Jim
Published: May 2014

This comprehensive and attractive paediatric textbook is primarily aimed at the medical student market. However, there is much in its content which children’s and young people’s nurses will find accessible and highly useful. Whether in training or already qualified, children’s nurses will find that this book offers valuable background reading.
PPI: making a difference
Authors: Clayton Michael
Published: May 2014

While the notion of involving children, young people and their families in healthcare planning is not new, for many practitioners this challenge is not one for which they can prepare or receive training in.
Practices and perceptions of family-centred care among children’s nurses in Ireland
Authors: Murphy Maryanne , Fealy Gerard
Published: May 2014

Family-centered care embraces the child and family as a unit and encourages the inclusion of the family in both the planning and provision of the child’s care in the health-care setting. Children’s nurses have signified their acceptance and knowledge of family-centered care and they have also indicated that they do not always incorporate this knowledge into their practice. The literature suggests that children’s nurses find it easier to offer descriptions of family-centered care than to implement it in practice.

While a wealth of literature relating to family-centered care practices from an international perspective exists, there was a dearth of literature on family-centered care practices among children’s nurses in Ireland. Descriptive quantitative methodology was employed to guide this study. Data were collected using the Family-Centered Care Questionnaire Revised on a purposive sample of 300 children’s nurses in two children’s hospitals in Ireland. The findings of this study concur with international literature; as significant differences were found in the respondents practice and perception of family-centered care.
How does clinical supervision impact on staff development?
Authors: Rouse Joanne
Published: May 2014

The aim of the study was to examine how clinical supervision impacts on staff development within acute paediatric care settings. The author analysed existing work, definitions and understanding of clinical supervision and explored the experiences of clinical supervision on staff working in paediatric wards and the effect of the clinical supervision on staff development.

The first part of this study was quantitative and involved participants who were registered child health nurses and non-registered nursing staff (n= 24). The second part was a qualitative study, involving registered child health nurses (n=4) and non-registered staff (n=2). The research was carried out at two acute paediatric wards at two hospitals comprising one NHS Trust.

The research incorporated a mixed-method approach. Initially a quantitative study using the Likert scale of measurement was conducted inviting all participants of clinical supervision to be involved. Secondly, a qualitative study, informed by phenomenology, was conducted using semi-structured interviews.

While the image of clinical supervision continues to require embedding within nursing culture, positive effects of clinical supervision on paediatric staff development such as reflection on practice, autonomy and problem solving, are experienced by the participants.

Development, as a result of clinical supervision, occurs both on a personal professional level and on a team level. Further study into the view of managers on the importance of clinical supervision and the role of the supervisor is required.
What impact do NHS reforms have on the provision of children’s services in England? The views of senior UK children’s nurses
Authors: Ellis Judith , Glasper Edward Alan
Published: May 2014

At the summer 2006 meeting of the Association of Chief Children’s Nurses (ACCN) held at The Evelina Children’s Hospital, London, the group were asked by a senior government advisor at The Department of Health to consider what impact NHS reforms have had on the provision of children’s services in England. Because of time restraints it was decided to address the issue through a Delphi study in which the first round to develop the initial criteria was ascertained through a focus group activity at the meeting. Nineteen senior children’s nurses attending the meeting participated in the focus group activity. Forty items were generated at this initial focus group meeting and which afterwards formed the basis of the Delphi instrument. Two subsequent Delphi rounds were conducted by email to endorse or reject the initial findings compiled from the focus group meeting. The Delphi study was conducted over an eight week period and 11 chief children’s nurses from children’s hospitals and units in Wales, Scotland and England responded to rounds two and three. The second and third rounds of the Delphi study utilized a five-point Likert scale in which respondents were able to strongly agree, agree, disagree, strongly disagree or express neutrality to each of the 40 focus group generated statements which became the Delphi instrument. Consensus in this study was defined as 70% of the Delphi panel study (8/11) strongly agreeing or agreeing after round three with a statement describing the impact of NHS reforms. A number of themes in which more than 70% of the respondents agreed or strongly agreed that the NHS reforms have had an impact on the provision of children’s services in England emerged from the data. These included the questionable benefits and long-term value of audits, the sensitivity of payment by results tariffs, the adverse effects of the reconfiguration of clinical services, the vulnerability of the role of the clinical nurse specialists whose added value is not recognized in the tariffs and the difficulties in implementing the common assessment framework among others.
Uncovering the hidden gems
Authors: Long Tony
Published: May 2014

The Journal of Children’s and Young People’s Nursing (JCYPN) recognizes that not all worthwhile projects and developments are earth-shattering or of international significance. Much more commonly, the projects that really make a difference are undertaken locally or regionally in order to fix a specific problem, to develop locally-relevant practice, or to evaluate a dedicated service. These are important works and they often reflect the difficulties and needs faced by others in far-flung parts of the country. Whole solutions may not always be directly applicable, but our colleagues in other areas may learn from the approach, make use of instruments or protocols, or even simply realize that they, too, have the same problem, hitherto unrecognized.
The rising tide of alcohol abuse among young people
Authors: Glasper Edward Alan
Published: May 2014

As the festive season approaches it is worth noting the launch of the Alcohol Health Alliance which was officially announced on 13 November 2007 under the auspices of the Royal College of Physicians ( www.rcplondon.ac.uk/alcoholalliance/ ). The alliance is consists of 21 auspicious bodies including the Royal College of Nursing (RCN), all of who are concerned at the rising medical toll of alcohol misuse
How does clinical supervision impact on staff development? Part 2
Authors: Rouse Joanne
Published: May 2014

The aim of the study was to examine how clinical supervision impacts on staff development within acute paediatric care settings. The author analysed existing work, definitions and understanding of clinical supervision and explored the experiences of clinical supervision on staff working in paediatric wards and the effect of the clinical supervision on staff development.

The first part of this study was quantitative and involved participants who were registered child health nurses and non-registered nursing staff (n=24). The second part was a qualitative study, involving registered child health nurses (n=4) and non-registered staff (n=2). The research was carried out at two acute paediatric wards at two hospitals comprising one NHS Trust.

The research incorporated a mixed-method approach. Initially a quantitative study using the Likert scale of measurement was conducted inviting all participants of clinical supervision to be involved. Secondly, a qualitative study, informed by phenomenology, was conducted using semi-structured interviews.

While the image of clinical supervision continues to require embedding within nursing culture, positive effects of clinical supervision on paediatric staff development such as reflection on practice, autonomy and problem solving, are experienced by the participants.

Development, as a result of clinical supervision, occurs both on a personal professional level and on a team level. Further study into the view of managers on the importance of clinical supervision and the role of the supervisor is required.
Continuing professional development
Authors: Farelly Rory
Published: May 2014

We often hear that children’s and young people’s nursing is changing more than ever before. It remains a view inextricably linked to development programmes for all staff including those who are newly qualified. A very exciting opportunity now exists in NHS Scotland, known as Flying Start NHS which is the national development programme for all newly qualified nurses, midwives and allied health professionals in NHS Scotland. It has been designed to support the transition from student to newly qualified health professional by supporting learning in everyday practice through a range of learning activities available on the left hand side and additional support from work based mentors.
Obesity: hidden costs to mother and child
Authors: Glasper Edward Alan
Published: May 2014

Levels of obesity among children in the western world have been increasing at an alarming rate. Between 1995 and 2003 obesity rates among children aged between two and ten years of age accelerated from 9.9% to 13.7% (Jotangia et al, 2006). The long-term implications on the nation’s health and the burden it will cause to the NHS and the nursing workforce in years to come, if it is not tackled, effectively is already a cause of major concern. This concern is emphasized by new statistics from the Confidential Enquiry into Maternal and Child Health (CEMACH, 2007) which show that more than half of the 295 women who died during or after pregnancy between 2003 and 2005 were overweight or obese. This is important because any increase of obesity within the childhood population is likely to impact on obesity levels within the adult population, not least among young mothers.
Empowering families via a dedicated website
Authors: Battrick Cath
Published: May 2014

In contemporary western societies information is sought on every subject, as demonstrated by the huge success of the Internet. It is therefore germane to note that patients and, in particular, the parents of sick children now desire more information than ever before because a variety of information is believed to empower parents to take charge of their children’s care and to assert their needs in a health-care world which has traditionally been dominated by professionals.
The NMC consultation on the review of UK pre-registration nurse education: the views of children and young people
Authors: Callery Peter , Ellis Judith , Glasper Edward Alan , Horsley Angela
Published: May 2014

As part of their consultation on the future of pre-registration nurse preparation, representatives of the Nursing and Midwifery Council (NMC) attended a symposium at the Hospital For Sick Children, Great Ormond Street, London, at which members of the Association of Chief Children’s Nurses (ACCN) and academic colleagues from Institutes of Higher Education around the UK debated aspects of the consultation, in particular, the NMC review issue:
The concerns of children’s and young people’s nurses
Authors: Glasper Edward Alan
Published: May 2014

Dear Prime Minister, Re The Nursing and Midwifery Council review of the future configuration of pre-registration nursing (November 2007–February 2008) and its potential to negatively impact on the UK provision of Children’s and Young People’s Nurses.
Facilitating student nurses’ learning using online enquiry-based activities
Authors: Jepson Jenny
Published: May 2014

Health and social care pre-qualifying education has a long established association with small group learning and teaching. The transition from traditional learning and teaching approaches to the use of a Virtual Learning Environment within Higher Education Institutes is not without its complexities.

This paper presents evidence from a previous pilot study exploring the use of an online learning activity and discusses how the findings have influenced the development of online scenario-based learning activities.

A review of current health-care literature informs the developmental processes, which include using a pedagogic framework for implementing a specifically designed online learning activity developed to allow child health student nurses to follow an online evidence-based enquiry learning process.

This paper, written as the online activity process is being introduced to child health branch student nurses, discusses the benefits and challenges of developing the activity and debates the facilitation of an evidence-based approach through autonomous student learning to all branches of pre-registration nursing programmes.
Valuing play for sick children in contemporary child health settings
Authors: Battrick Cath
Published: May 2014

Coles et al (2007), in an audit of compliance by a number of hospitals to standard 7 of the National Service Framework (NSF) For children, Young people and Maternity Services, showed that play provision for children in hospital was less than optimum. The lack of play services in areas such as outpatient departments and emergency departments was a contributory factor to some hospitals being awarded low scores.
Hyaluronic acid: essential properties and considerations for aesthetic practice
Authors: Fromage Gemma
Published: May 2014

Generally, by the age of 30 years, structural changes start to become noticeable on the face. The redistribution of fat, combined with both the loss of bone and soft tissue volume and decreased dermal elasticity and thickness, contribute to the formation of fine lines, wrinkles and folds. In the past, surgical procedures were the dominant method for tackling signs of facial ageing. However, this two-dimensional technique is giving way to the three-dimensional volume restoration that dermal fillers provide. Hyaluronic acid (HA) is present among all living organisms and plays an integral part in the maintenance and regulation of moisture within tissues, due to its high affinity for water. There are a number of factors affecting the properties of each HA-based filler on the market, including molecular weight, cross-linking, swelling, modulus and particle size and distribution. Each dermal filler is appropriate for different areas and types of treatment. Although there is no single filler that is appropriate for every type of treatment in all patients, correct adjustments of the above properties could lead to the production of a more ‘ideal’ dermal filler.
Important points in sharps safety
Authors: Blenkharn Ian
Published: May 2014

Sharps injury among health professionals is a devastating event, risking severe stress and debilitating post-traumatic anxiety, even in the absence of seroconversion. Effective prevention requires comprehensive training and education of all staff, who must comply with evidence-based policies and procedures based on detailed risk assessment. Safer working is supported by safety engineered sharps devices, now mandated by specific sharps safety legislation unless retention of an older non-safety device is demonstrably unavoidable. Costs may be high and some trusts provide only the cheapest sharps safety devices, claiming overwhelming cost pressures. However, safety performance when using lower cost active safety devices may be less than with the fully automated passive devices that require no user intervention to default to a safe condition. Carefully crafted sharps policies and procedures should shape and be supported by comprehensive training and periodic audit. Detailed investigation must be undertaken in relation to any incidents and near misses, including those occurring as wastes pass from the clinical area, along the disposal chain, in the hands of porters and ancillary staff, waste handlers and laundry workers.
Influences on relationship-based health visiting, part 2: Discovering the need for balance through a new epistemology
Authors: Pound Robyn
Published: May 2014

In the second part of a two-part article, the personal, professional and organisational influences on relationship-based practice clarified in part 1 are explored further, with the author reflecting on experiences and discussions with parents, colleagues and researchers. Using living theory methodology, in part 2 the author begins exploring influences of practitioner personality, fears, anxiety, autonomy, training, evidence building and organisational climate. Balance emerges as an additional value in the author's ‘alongside’ practice for managing these tensions. She calls for a wider shift towards the same qualities of relationships expected in families to be practised across organisations with children's wellbeing in mind. Further, she concludes by calling for a new epistemology of practice that is capable of integrating the practising, training and researching of health visiting by embracing contradictory experiences occurring in living relationships.
Female genital mutilation: The legal framework
Authors: Townley Lynne
Published: May 2014

Following the announcement of the first prosecutions for female genital mutilation in the UK, this article considers the legal framework and best practice for professionals.
Caring for patients with peritoneal dialysis catheters and exit sites
Authors: Wild Janet , Ansell Toot
Published: May 2014

Janet Wild and Toots Ansell give a step-by step account of how to look after patients opting for peritoneal dialysis from the insertion of a catheter, the immediate post-operative care of the exit site, and the long-term care needed to keep the wound clean and infection-free.
Treating anaemia in children with chronic kidney disease
Authors: Reid Chris
Published: May 2014

Chris Reid looks at how common anaemia is in children with chronic kidney disease (CKD) and what impact it may have. He then gives an overview of the current guidelines for treating renal-related anaemia and how treatment plans differ for children compared with adults.
After my transplant—not all rosy
Authors: March Peter
Published: May 2014

Peter March gives his account about life after kidney transplantation, which had left him more physically disabled and psychologically affected than he had imagined or been prepared for. His story holds many lessons on how to prepare and inform patients for their lives after transplantation.
The paediatric renal staff nurse: care coordinator within the renal team
Authors: White Ellen
Published: May 2014

The role of a paediatric renal staff nurse within the renal team is multifaceted. An expert nurse will combine a multitude of roles and responsibilities in order to coordinate child-prioritizing and family-centred care. Ellen White explains some of the aspects of the job and the importance of working as part of the multidisciplinary team to help provide an exceptional renal service.
Care bundles: are they of use in renal care?
Authors: Thomas Nicola
Published: May 2014

Care bundles are groups of high-impact, evidence-based healthcare interventions that can improve clinical and patient-reported outcomes—one way of implementing ‘smarter working’. Nicola Thomas describes the current evidence for care bundles and evaluates whether using a care-bundle approach can improve the care and management of people with chronic kidney disease.
Back to basics: more complications of haemodialysis
Authors: Ellis Peter
Published: May 2014

Intradialytic hypotension (IDH) is the most common complication of haemodialysis (HD). The last article looked at the causes and prevention IDH, while in this article Peter Ellis describes the management of IDH. Patients experiencing IDH may lose consciousness and start vomiting, nurses are then required to perform immediate life-saving actions to prevent loss of life.
Nocturnal home haemodialysis
Authors: Warren Madeleine
Published: May 2014

Madeleine Warren gives an inspirational account about her life, which includes considerable set-backs in her renal therapy treatment. However, nothing could dampen her positive and life-embracing attitude. Finally, with nocturnal home haemodialysis, she can live her life to the full—fuller even.
A new approach to psychological support in the renal setting
Authors: Cove Jeff
Published: May 2014

There is wide scope for psychologists to contribute to secondary prevention in non-reversible medical conditions such as end-stage renal disease (ESRD): reducing further avoidable health deterioration through enhancing patients' adjustment and adherence to medical advice and treatment. Two phases in patients' journeys are particularly significant, their transition from the pre-dialysis clinic to dialysis-based renal replacement therapy (RRT) and their assessment for transplantation. We devised structured interviews with patients in these stages aimed at identifying and addressing illness acceptance issues and barriers to future adherence, delivered through clinics run in parallel with nursing and medical colleagues. They have broadened our understanding of both staff and patient concerns about transition to RRT or listing for transplants and provided a context for both brief preventive and further follow-up work. Key to enhancing psychological preparedness has been exploring the meaning ascribed to the forthcoming change and patients' personal health beliefs, in the context of their broader life situation, values and goals.
Anaemia management in chronic kidney disease patients
Authors: Pagels Agneta A , Hylander Britta
Published: May 2014

Aims and objectives: To explore dosing patterns and self-injection barriers in administrating erythropoiesis-stimulating agent (ESA) treatment in patients with chronic kidney disease, not on dialysis (CKD-ND). Method: In a multicenter, cross-sectional study in Sweden, 385 CKD-ND patients were assessed for ESA administration patterns and barriers to self-injection. Results: 121 participants (31%) did not self-inject ESA. Of the assisted patients, 88 (73%) had ESA administered by district nurses and 33 (27%) by relatives. Assistance was more common among patients ≥65 years. Injection fear, uncertainty, convenience and physical handicaps were common barriers to self-injection. Conclusions: A range of barriers may influence the patients’ ability to self-inject ESA. These should be addressed and further elucidated. Renal nurses as well as other caregivers need to explore the patients’ perspective, address injection related anxiety, handling difficulties and support and educate CKD-ND patients to enhance their self-care agency regarding anaemia management.
A review of acute peritoneal dialysis
Authors: Ellis Peter
Published: May 2014

Peter Ellis outlines the pros and cons of acute peritoneal dialysis—the first form of dialysis used in the management of acute kidney injury—is growing, and outlines those patients who may benefit most from it.
Hepatitis B: virus and vaccination in patients with renal impairment
Authors: Eaton Christopher , Chai Mee Onn
Published: May 2014

Renal patients are at particular risk of hepatitis B virus (HBV) infection. As HBV infections are difficult to treat despite the availability of antiviral therapies, disease prevention by timely immunisation is paramount. Christopher Eaton and Mee Onn Chai give an excellent overview of hepatitis B—from outlining the risk factors for infection, interpreting virology results to scheduling the vaccinations.
Managing anaemia in pregnant women with chronic kidney disease
Authors: Bennett Lesley I , Wittwer Iain E , Judge Parminder K
Published: May 2014

Despite the fact that women with chronic kidney disease (CKD) experience a decrease in fertility and an increased likelihood of miscarriage, the success rate for live births in these women is growing. As declining kidney function puts them at a greater risk of developing anaemia, health professionals must be vigilant in monitoring and managing anaemia to prevent clinical complications occurring throughout gestation and birth. This article aims to raise awareness of this important topic.
The emotionally resilient renal manager: understanding the language of emotion
Authors: Ellis Peter , Abbott Jane
Published: May 2014

Emotional resilience is one of the many tools that effective renal managers use to deal with everyday stress. In this article, Peter Ellis and Jane Abbott define emotional resilience, then investigate when its use is appropriate and how it may be learnt.
New fears surrounding the spread of variant Creutzfeldt-Jacob disease
Authors: Biela Chris
Published: May 2014

In humans, variant Creutzfeldt-Jacob disease (vCJD) is a fatal, non-curable brain disease. It has been estimated that 1 in 2000 of the population could unknowingly be silent carriers of the prion responsible for the disease. Chris Biela discusses the impact of vCJD on organ transplantation.
Pressure sore survey Part 2: nurses' knowledge
Authors: Maylor M. , Torrance C.
Published: May 2014

This is the second of a three-part article which investigates the prevalence of pressure sores and nurses' knowledge and attitudes in one NHS trust. This study was designed to explore the assumption that lack of knowledge might be a contributory factor to pressure sore formation. A cross-section of trained and untrained staff over several areas of work in the acute and community settings were represented.

Overall, the differences in awareness and opinions among staff were not indicative of major deficits in knowledge that could account for failure to prevent pressure sores. It is suggested that the problem may well be one of individual or organisational motivation.