bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid access to information: the key to cutting costs in the NHS
Authors: Fitzsimmons Paul
Published: May 2014

The hiatus is over. The Treasury has made it very clear-the NHS has to make tough cuts, now. And the coalition government is demanding clinician-led decisions in order to minimise the impact on the quality of front-line service delivery. Good in theory, but without rapid access to cross-functional informatics, clinicians are powerless. Today's mass of siloed information may enable reporting on prescriptive targets, but it provides limited insight into performance variations or the cost of service delivery.
Competition in a shrinking NHS market
Authors: Leech Darren , Willis Rob , Jones Cassie
Published: May 2014

The coalition government has set out what it is describing as the most radical set of changes for the NHS since its inception. The White Paper,‘Equity & Excellence: Liberating the NHS’( Department of Health (DoH) 2010 ) includes considerable reforms to organizational structures within the NHS, cutting management costs in some areas by 45% and saving £20 billion by 2014. These headline grabbing elements of the white paper are something likely to preoccupy many of those currently involved in the leadership and management of health services in England. This is unfortunate as the distraction of structural change to organizations has previously been seen as a causal factor of non-delivery, in both public and private sector organisations. This new era for the health service will result in many issues for leaders and managers in the NHS to tackle. For instance, one consideration that prompts debate is that of further enhancing the ethos of competition between healthcare providers and indeed, between commissioners too. While the White Paper reassures the reader that competition will be regulated through an OFGEM/OFCOM like Monitor, it is also explicit that the principle of competition will be further promoted. Of course the notion of enhanced competition between providers of NHS services is not new, as the last government also promoted this concept—for example, through greater ‘choice’ as a mechanism for driving up quality.

In the many other sectors of the business world where competition is well established, the general research shows us that as competition increases, ‘business ethics’ and ‘moral leadership’ are likely to be matters of greater concern for the likely leaders and managers of our future NHS.
Empowering the frontline of healthcare delivery
Authors: Ojo Olurotimi
Published: May 2014

The pledge to empower clinicians, particularly those at the frontline of healthcare delivery, remains an enduring feature of successive waves of healthcare policy reform since the Labour landslide of 1997. The current Conservative/Liberal coalition proposals for health care reform are no different and indeed are more radically ‘empowering’ in ambition and scope. This article looks at empowerment through the lenses of organisational culture and human resources management in an attempt to understand why empowerment as a strategic objective remains difficult to deliver at the frontline.
Hierarchical regionalism and the rise of AHSNs
Authors: Davies Stephen M
Published: May 2014

The term ‘hierarchical regionalism’ describes a key organisational principle, which is that health services are best organised on a rational, hierarchical basis across on a regional scale. Until the 1970s, policy-makers assumed that organising services in this way was sufficient to ensure the diffusion and adoption of innovation and best practice. The ‘intermediate tier’ structures created by the 1974 NHS reorganisation had another purpose, which was to strengthen the ability of the centre to control the periphery. However, regional-level authorities have maintained a remit for planning, co-ordination and quality improvement alongside this performance management role. In 2013 the current structures of the intermediate tier will be dismantled. In mid-2012 there was a plethora of new bodies emerging to fill a soon to be vacated space. These include academic health science networks (AHSNs). Policy towards AHSNs reflects international influences but with the British modification of seeking comprehensive, regional coverage. Two possible scenarios for the future are envisaged. In one of these the AHSN becomes the dominant structure in the intermediate tier. If this happens, then hierarchical regionalism will have been reborn as the key organising principle for the NHS in England.
Patient access schemes in the new NHS
Authors: Spoors John
Published: May 2014

Patient access schemes (PAS) have become an integral part of the UK pharmaceutical environment. This article investigates the historical role PAS have played in regard to health technology appraisals (HTAs), how the mechanism interacts with other features of the UK funding environment, such as the Cancer Drugs Fund (CDF), and the PAS strategies employed by pharmaceutical companies to optimise funding recommendations. It also takes a forward look towards any role PAS might have in a value-based pricing system, which is potentially facing the UK from 2014. PAS have shifted from outcome-based schemes to financially-based discounts. It is clear that as PAS have become more integral to the UK HTA environment, an acceptance of confidentiality and a requirement to prove that PAS reduce uncertainty to payers are two major developments. The article also highlights how the CDF may act as a potential disincentive for manufacturers to engage with PAS and provide the NHS with discounts to achieve cost-effectiveness. The key going forward is stability; providing a framework which allows payers to determine value, but permits pharmaceutical companies to exist in a credible pricing operating environment.
Mid Staffs: lessons from history
Authors: Harvey Trevor
Published: May 2014

Following the publication of the Francis report, Trevor Harvey asks what lessons can be learned
Electronic document management systems: benefits and pitfalls
Authors: Kain Nakul , Koshy Ommen
Published: May 2014

Electronic Document Management System (EDMS) is a system that enables patients’ clinical paper notes to be scanned onto an electronic document allowing access by an authorised user on a hospital computer. EDMS was adopted by St Helens & Knowsley Teaching Hospitals in October 2008. It was the first hospital trust in the UK to shift from paper to online patient records. Over the years the benefits and pitfalls of the system have become more apparent and in this article the authors wish to discuss our experience and suggest some improvements.
Early warning signs of persistent complainants
Authors: Skilling Gordon , Øfstegaard Marianne , Brodie Sara , Thomson Lindsay
Published: May 2014

Using a retrospective case control study of 60 complainants from a Scottish police force and from the Police Complaints Commissioner for Scotland (PCCS), we aimed to devise a set of early warning signs to allow for the identification of complainants likely to become unusually persistent, and to examine the use of complaint management strategies in these cases. There were significant differences between the unusually persistent complainants and the other groups. There were several key complaint handling strategies that were not used. Early warning signs could potentially identify a group of complainants ‘at risk’ of becoming unusually persistent. Appropriate complaint handling strategies could be implemented both early and later in the complaints process to increase the likelihood of a successful outcome for both complainants and public bodies and lead to significant cost savings across the public sector.
Operational efficacy of the midnight census
Authors: Khanna Sankalp , Boyle Justin , Good Norm , Lind James
Published: May 2014

As encumbered hospital services take on the pressures of rising demand and reduced funding, improving capacity management and patient flow through the service become increasingly critical tasks. Effective capacity planning relies on accurately estimating the demand for services and the dynamics of patient flow. This paper presents our efforts to analyse the efficacy of the midnight census, the globally used hospital occupancy measure, in informing capacity planning initiatives. We analyse data from 23 public hospitals in Queensland, Australia, and examine the relationship between midnight census and peak, average and minimum occupancy levels. Lagged relationships with the day before and week before are also investigated. Our findings show that midnight census from the day before is a good predictor of expected peak and average occupancy levels. However, for timely capacity management using measures from the week before, peak and average occupancy outperform midnight census, providing better correlation and narrower prediction intervals.
‘Choose and Book’: are patients ill informed?
Authors: Ecclestone Hazel , Blades Rosie
Published: May 2014

‘Choose and Book’ (CaB), part of the government's National Programme for IT, was rolled out in the NHS in 2006. It aims to empower patients by offering them unrestricted referral to health service providers. Patient choice has been a key element in successive governments; yet little research exists into what motivates patient choice. This audit looked at referral pathways over a four-week period in 2010 to establish how patients had been referred; and if referred via CaB, what factors motivated their choice. Only 50% of patients were referred via CaB. Of those given a choice of providers, 46% chose the closest hospital and 18% chose the shortest waiting time. The results show that the patient makes choices based on everyday practicalities rather than quality of healthcare provider as they are potentially ill informed and disempowered to decide on the basis of any other factors.
Research Round-Up
Authors: Mestecky Ann-Marie
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
CORRESPONDENCE
Authors: Fitzpatrick Maria , Matta-Noaman Kris
Published: May 2014

The use of physical restraint in the UK remains a controversial and emotive topic for patients and health professionals. Mary Braine discusses some of the legal and ethical issues surrounding this subject (Br J Neurosci Nurs 1(4): 177-83). In the field of neuroscience nursing restraint may be used to ensure the patient receives the appropriate treatment and to provide a safe environment. As a clinical nurse specialist for stroke, I have often had to consider this issue, and after contacting other stroke units and conducting a detailed literature search to review current practice around the use of restraint I found that no clear guidelines were available. I therefore developed a policy for the use of physical restraint for patients in the acute phase of stroke to prevent them from pulling and dislodging their nasogastric tube. The trust′s legal department and senior nurses were involved in reviewing this policy.
Epilepsy and pregnancy: More information needed
Authors: Hillman Erika
Published: May 2014

Erika Hillman argues that mothers who have epilepsy require more information about the potential for abnormalities at birth as a result of the drugs and the disease.
Rivastigmine licensed for dementia in Parkinson's
Authors: Meadowcroft Robert
Published: May 2014

Robert Meadowcroft considers the implications of a licence extension for a dementia drug for use in Parkinson's, and how NICE might respond.
Not nice: Penny-pinching ignores the patient
Authors: Benbow Susan
Published: May 2014

On 26 May, the National Institute for Health and Clinical Excellence (NICE) announced its review on the use of acetylcholinesterase inhibitors and memantine for the treatment of Alzheimer's disease (2006a, 2006b) (Table 1). These recommendations are subject to appeal, and a final decision is expected in July.
The evolution of a relapse clinic for multiple sclerosis: Challenges and recommendations
Authors: Matheson Fiona , Porter Bernadette
Published: May 2014

The delivery of care for people with multiple sclerosis (MS) has evolved considerably in recent years. This paper describes the evolution of a nurse-led relapse service provided within the multidisciplinary MS team in a large teaching hospital. This paper explores those components which were most important to the success of this service, including patient support and education within an expert-patient framework, nursing assessment skills and telephone triage, extended nursing roles, and the development of an integrated care pathway.
BOOK REVIEW
Authors: Woodward Sue
Published: May 2014

This is a new title in the Essential Clinical Skills for Nurses Series. The book is aimed at students and registered nurses caring for patients with neurological conditions, focusing on practical care of the patient in a nonspecialist setting. A series of case studies is used throughout the book to illustrate a number of points.
Experience of the application of music in the care of a patient with intracranial haemorrhage
Authors: Lee Huan-Fang , Chiang Hui-Ying , Chi Wan-Yu
Published: May 2014

The focus of nursing care of patients with severe head injury has shifted from controlling intracranial pressure to increasing cerebral perfusion pressure, and the stabilization of patients' vital signs can help maintain intracranial pressure and cerebral perfusion pressure. This paper discusses the experience of using music to stabilize the post-operative vital signs of a patient with intracranial haemorrhage. The data were collected through physical assessment, continuous observation and medical record reviews. The results support previous findings that music may help stabilize a patient's vital signs as well as achieve a tranquillizing and analgesic effect.
Give Alzheimer's drugs time to work
Authors: Glynn Owen Olwen
Published: May 2014

With NICE guidelines subject to appeal, a survey of prescribing reveals some interesting results, writes Olwen Glynn Owen.
RESEARCH ROUND-UP
Authors: Crawford Belinda
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
CORRESPONDENCE
Authors: MacLean Rhona
Published: May 2014

Working in health and social care at the current time can be a challenging experience, as many changes are taking place at both local and national level. One of the major changes that is occurring is the reform of both health and social care, as set out in the White Paper, Our Health, Our Care, Our Say (Department of Health (DH), 2006). The four main goals of the White Paper are:
Flaws in the microchip: Technology can fail
Authors: Woodward Sue
Published: May 2014

In this issue, Sue Thomas, Nurse Policy Advisor for the Royal College of Nursing, identifies a change to the way in which nurses practise and how care is now delivered to some patients (p. 481). While the introduction of new ways of working and innovation to service provision is to be welcomed, we must keep in mind whether ‘SMS nursing’ will be beneficial to all our patients. One way in which it has been suggested that text messaging may be used is as a reminder service for people to take medication. Many patients with long-term neurological problems are elderly and do not own a mobile phone, so a service which sends text messages to remind them to take medication for example, would not be helpful.
Nursing by SMS: Support via text
Authors: Thomas Sue
Published: May 2014

How times change. Many years ago, when I was working as a district nursing sister, a nurse working in my locality was disciplined for contacting patients by telephone rather than conducting face-to-face visits. Her rationale for calling patients rather than actually visiting them in person, was that she was giving the patients ‘support’ rather than hands-on care. Many of these individuals had long-term conditions and she was trying to encourage them to ‘keep well’. Nevertheless, at that time this method of working was certainly not acceptable to management and she was disciplined. I trained, as you will see from my picture, many years ago when we were by and large an NHS that did not really empower patients to ‘self-care’, with developments such as the Expert Patients Programme not yet appearing on the NHS radar.
Distinguishing between seizure types in adult epilepsy: A key role for nursing observations
Authors: Mantri Pamela
Published: May 2014

Epilepsy is the most common serious neurological condition, with an estimated prevalence of about 0.75% in the developed world. With approximately 40 types of epilepsy seizure now defi ned, in addition to more than 30 epilepsy syndromes and conditions, it is more appropriate to refer to the epilepsies.

Epilepsy syndromes and seizure types have different prognoses and require different management strategies. Inaccurate diagnosis may result in suboptimal management. It is therefore essential to identify a person's epilepsy syndrome and seizure type as fully and accurately as possible through careful history-taking using a comprehensive understanding of seizure types and syndromes.

There is currently no international consensus on the classifi cation of epilepsy seizures and syndromes. Advances in technological, medical and biological knowledge have rendered the current classifi cation of epileptic seizures published by the International League against Epilepsy (ILAE) in 1981 out of date, but despite ongoing debate, no replacement classifi cation has yet been accepted. A diagnostic scheme published in 2001 by Engel offers clinicians a more up-to-date terminological framework for use in clinical practice. It is important for nurses involved in the diagnosis and ongoing review of patients with epilepsy to understand the new and revised terms and concepts in the context of advances in the understanding of the neuropathophysiology of the epilepsies. Correct diagnosis of a patient's epilepsy is necessary for appropriate management.
Research Round-Up
Authors: Hibbins Stuart
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the fi eld of the neurosciences. The aim of this roundup is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Emotional support after stroke, part 2: A community practice model
Authors: Bennett Bev , Greensmith Chris
Published: May 2014

The first of this series of two articles on the importance of emotional support after stroke focused on two examples from hospital-based practice (Bennett et al, 2007). It was recognized that, although support is essential in the period immediately following a stroke, emotional distress may persist long after the person has been discharged from hospital care. It is more likely that the full impact of the stroke will not be experienced by a patient and his/her carers until he/she has returned home; psychosocial adjustment is often gradual and prolonged. A specialist mental health nurse can provide much needed emotional support in this situation.
Revised NICE guidance on drugs for Alzheimer's disease and its impact on patients and carers
Authors: Hudson Helen
Published: May 2014

In November 2006 the National Institute for Health and Clinical Excellence (NICE) published the final review of its guidance on the use of anticholinesterase drugs and memantine hydrochloride for the treatment of Alzheimer's disease. Recommendations included a reduction in the use of anticholinesterase drugs, limiting them to the treatment of patients in the moderate-to-severe stages of the disease and an end to the use of memantine for newly diagnosed patients. This article examines the impact of this NICE decision on those people suffering from Alzheimer's disease and their carers and families.
Is neuroscience nursing adding value to care?
Authors: Newbold David
Published: May 2014

The Dementias and Neurodegenerative Diseases Research Network (DeNDRoN) supports a fresh approach to clinical research: its aim is to place NHS expertise and resources at the centre of a quality research infrastructure, improving both the speed of research and the integration of best practice into patient care. Its core aims include timeliness of trial set-up, support for recruitment and the provision of a trained workforce to facilitate the conduct of quality research.
Brain tumour treatments: the view of patients and caregivers
Authors: Oliver Kathy
Published: May 2014

Brain tumours need to be given a greater and more urgent focus of attention, say patient groups. Kathy Oliver highlights a campaign for NHS-funded access to promising therapies for this disease
The care of patients with subarachnoid haemorrhage in the emergency department
Authors: Spratt Patricia , F Cook Neal , Gillespie Mark
Published: May 2014

The arrival of individuals with headache in the emergency department presents the nurse with many unique challenges, and about 12–25% of all patients presenting to accident and emergency with an acute sudden severe headache have a subarachnoid haemorrhage. The effective management of subarachnoid haemorrhage is based on with prevention, early and accurate diagnosis, and correction of complications. This article provides an overview of some of the key considerations required for evidence-based care of subarachnoid haemorrhage in the accident and emergency department. A number of recommendations for an holistic approach to care are proposed.
Short-term cuts deprive patients of necessary specialist care
Authors: Masham Baroness
Published: May 2014

I was very pleased to obtain a short debate on the need for specialist nurses on 1 May 2007. I have become aware of the great concern among voluntary organizations, patients, carers and specialist nurses that the NHS hospital trusts and the primary care trusts are cutting the specialist nurse posts or not replacing specialist nurses when their positions become vacant.
Addressing information needs on acquired brain injury
Authors: Tyrer Stephen , Nesvaderani Elnaz
Published: May 2014

The United Kingdom Acquired Brain Injury Forum (UKABIF) is a charity set up in 1998 to improve awareness of the effects of acquired brain injury and related service needs including prevention, treatment, rehabilitation, health and social welfare, education, housing, work, financial factors, legal issues, civil rights, ethnic concerns and other issues affecting people with a brain injury arising from whatever cause.
The voice of neuro-nursing resounds from Reykjavík
Authors: Christine Eberhardie
Published: May 2014

The European Association of Neuroscience Nurses (EANN) held its eighth quadrennial congress in Reykjavík, Iceland at the beginning of June. In its 28 years the EANN has grown from a largely western European organization to one which is reaching out to members in Eastern Europe, the Mediterranean and the Baltic. Its main meeting open to all neuroscience nurses is the quadrennial congress. It was an excellent opportunity for neuroscience nurses working in a wide variety of areas associated with the neurologically disabled to come together from all over Europe and the wider world. Present at this year's congress were specialists from units dealing with specific diseases such as stroke, Huntington's and Parkinson's disease, and neuro-oncology. Others had a more generic role across a variety of neurological disorders but were specialized by the stage of the disorder such as neurointensive care, neurosurgery, general neurology or neurorehabilitation.
Development of a tool for risk assessment to facilitate safety and appropriate restraint
Authors: Waterhouse Catheryne
Published: May 2014

Restraint is a method of involuntarily restraining the movement of the whole or a portion of a patient's body to control behaviour and prevent injury to the patient or others. Restraint has been correlated with poor patient outcomes, higher mortality rates, increases in hospitalization, nosocomial infections, pressure sores, and increased levels of confusion. It can often be extremely difficult to maintain patient safety without acting in a way that might provoke an allegation of abuse. The aim of this article is to discuss some of the difficulties that presented themselves to nurses in the Royal Hallamshire Hospital's neuroscience unit following a decision to justify actions to use restraints. The development of a functional risk assessment tool for use in cases of challenging behaviour is explained and its use discussed in relation to legal and consent requirements.
Book Review
Authors: Mills Helen
Published: May 2014

As the title suggests this book is all about one family's experience of living with Huntington's disease, a degenerative and incurable hereditary disease. The main author has Huntington's disease, and some of her family members each write a chapter so that there is a sense of balance for the reader. The reader does not need any knowledge of either the clinical aspects or experience of Huntington's disease as the book is written in an easy-to-read style.
A new year: New engagement with the NSF
Authors: Thomas Sue
Published: May 2014

Sue Thomas discusses the National Service Framework for Long-Term Conditions and a new range of initiatives planned by the Department of Health
Exercise as a neuroprotective mechanism in Parkinson's disease: Future treatment potential?
Authors: Ahmed Bushra Y
Published: May 2014

This review describes the effect of exercise on Parkinson's disease. Experimental studies have shown that exercise plays an important role in prevention of Parkinson's disease by increasing serum calcium level leading to rise in dopamine concentration. Furthermore, exercise inhibits the process of inflammation by activating anti-inflammatory molecules and therefore impedes dopamine-containing neuronal cell degeneration. The purpose of this article is to raise awareness of the importance of exercise for Parkinson's disease patients by discussing what is understood about the pathophysiology of Parkinson's disease and exploring how exercise can be useful in restoring lost functions and slowing the progression of disease.
Ataxia UK: Supporting people with progressive ataxia
Authors: Rooke Laura , Greenfield Julie
Published: May 2014

Laura Rooke and Julie Greenfi eld explain the works of Ataxia UK, a charity which offers support and information to patients and health professionals.
The NHS at 60: Looking to the future
Authors: Thomas Sue
Published: May 2014

Sue Thomas discusses the first 60 years of the NHS and how nursing and policy have changed throughout this time.
Yawning: The contagious disease
Authors: Winter George
Published: May 2014

George Winter wonders about the physiology of the yawn and our ability to devise one for every occassion.
The challenge for dementia nursing in the 21st century
Authors: Pointon Barbara
Published: May 2014

Barbara Pointon cared for her husband, Malcolm, for most of his journey with Alzheimer′s. She shares some personal views about ways to improve the care of people with dementia
Care for the person with dementia, 4: Challenges and changes in relationships
Authors: Beart Kirsty
Published: May 2014

The aim of this series of articles is to question the traditional view that the devastation of dementia is all that is left of a person and offer readers a resource for helping individuals and their carers live with dementia. Kirsty Beart conducted a series of interviews with ten pairs of people with dementia and their carers (Beart, 2006). This article is an extract focusing on themes identified as affecting a person′s emotional and psychological wellbeing, in particular, the relationship changes that result from dementia. Some guidance is offered on how people can deal with these issues.
Driving after a brain injury: Rules and assessment
Authors: Hassall Mandy
Published: May 2014

Mandy Hassall explains the law on driving after a brain injury and reviews the responsibilities of nurse, medical practitioner and patient
Filling the gaps in specialist nursing for people with Parkinson′s
Authors: Carter Lesley
Published: May 2014

The largest ever survey of people with Parkinson′s and their carers finds that the number one campaign priority is access to a specialist nurse. Lesley Carter reports
Medical eponyms
Authors: Winter George
Published: May 2014

George Winter contemplates the future of grammatical standards in Medicine
Views sought on ethics in dementia care
Authors: Hope Tony
Published: May 2014

Tony Hope explains the complex reasons why the Nuffield Council on Bioethics is holding a public consultation on the ethics of dementia care
The role of serotonin as a neurotransmitter in health and illness: A review
Authors: Opacka-Juffry Jolanta
Published: May 2014

Serotonin has long been implicated in the aetiology of a number of neurological and psychiatric disorders and, consequently, their current pharmacological therapies assume and target serotonin-related molecular abnormalities. This article outlines the background of the neurochemistry and function of serotonin as a brain neurotransmitter and focuses on its roles in the pathophysiology of migraine and depression, indicating the most pronounced trends in this area of research. This article is based on a small selection of influential reviews as well as examples of topical research papers to guide the reader through the field of research literature and to suggest a choice of high quality further readings.
Darzi Review is published
Authors: Thomas Sue
Published: May 2014

Sue Thomas discusses the aims and objectives of the Government's public consultation on health and social care, and encourages nurses to contribute
What do hospitalization data reveal about ways to reduce admissions of epilepsy patients?
Authors: Mantri Pamela
Published: May 2014

Adults with epilepsy are sometimes admitted to hospital as emergencies. It was expected that these admissions would be due to status epilepticus, injuries sustained during seizures and adverse side effects or toxicity from antiepileptic drugs. However, an examination of local hospital episode statistics showed that such hospital admissions were more complex. Age, sex and comorbidities influenced non-elective admissions. This study revealed that depression and alcohol and drug use were frequently associated with non-elective adult admissions for epilepsy, suggesting that seizure control was poorer with the presence of mental health problems and substance misuse. There is a paucity of literature to explain non-elective hospitalization of adults with epilepsy, and extant literature is contradictory. The results of this study can inform efforts to identify potentially avoidable hospital admissions and find alternative interventions or resources that may reduce or prevent some admissions.
Turning taboo into debate
Authors: O'Brien Mary
Published: May 2014

Craig Ewert, a 59-year-old former university professor, had his last moments filmed by Canadian director John Zaritsky for his documentary The Suicide Tourist (2008) broadcast on 10 December 2008 on Sky Real Lives. The programme, which showed the act of assisting a suicide for the fi rst time on UK TV, has inevitably raised the topic of euthanasia and ignited the debate on assisted suicide once more. The fact that the main subject of the fi lm was a man suffering from motor neurone disease (MND) means that it has specific relevance for neuroscience nurses.
Helping nurses help patients
Authors: Thomas Sue
Published: May 2014

It is important that neuroscience nurses and organizations with an interest in health policy-making approach government with a consistent message to infl uence policy. At the end of 2008, I was giving evidence to ensure the RCN's view on the value of neurology nurses was given to the Royal College of Physicians. The new year starts in the same vein with the RCN working on a consultation document to inform the government about access to specialist nurses for people with Parkinson's disease.
Injuries are no accident
Authors: McDonald Sheena
Published: May 2014

I normally respond positively to invitations to comment on head injury. My own experience of a very severe head injury has left me with a certain perspective on the injury itself, and the nature of recovery from such a trauma. However, a recent approach has given me pause for thought.
The Greeks will have a word for it
Authors: Ainsworth Steve
Published: May 2014

Anyone working in health care acquires a vast range of words specific to their profession. But few have time to pause and ask where all those words come from. Neurology, for example, and other ‘neuro-’ words have their origins in the ancient Greek word neuron which indifferently meant simply ‘nerve’, ‘sinew’ or ‘tendon’. Only in the 19th century was it borrowed to form a collection of clinical ‘neologisms’ (itself a 19th-century neologism from the Greek words for ‘new’ and ‘word’).
A survey of stroke nurses' knowledge of secondary prevention lifestyle issues
Authors: Lawrence Maggie , Kerr Susan , Watson Hazel E , Jackson Jennie , Brownlee Margaret G
Published: May 2014

Nurses have an important role to play in providing information and advice on lifestyle risk factors for recurrent stroke. However, patients report receiving little or no lifestyle information.

Aim: This study aimed to explore stroke nurses' knowledge and practice in relation to the provision of secondary prevention lifestyle information following stroke.

Design: Cross-sectional survey methods were used. Participants were members of the Scottish Stroke Nurse Forum (n=97).

Methods: A self-completed questionnaire was used to collect the data, with descriptive statistics summarizing the results.

Results: Respondents stated that they assessed lifestyle risk factors following stroke; however, they focused on some but not all risk factors. While written and verbal information and advice was provided, knowledge of guidelines and health-related recommendations was limited.

Conclusions: Stroke nurses require improved access to continuing professional development with regard to secondary prevention of stroke. They also require easy access to information resources which support evidence-based practice.
Cost saving may have adverse effects in controlling epilepsy
Authors: Clark Janet
Published: May 2014

Epilepsy is the UK's most common serious neurological condition affecting 1 in 131 adults in the UK. Around 75 people are newly diagnosed with the condition every day. Epilepsy can affect anyone, of any age at any time in their life. A diagnosis of epilepsy can have a devastating effect on the individual, his/her lifestyle and his/her family. Antiepileptic drugs (AEDs) are used to stop seizures happening—they do not cure epilepsy.
A strategy to make dementia care a priority
Authors: Hunt Neil
Published: May 2014

Dementia is a serious national priority—one in three people over 65 years in the UK will die with dementia, yet the UK is in the bottom third of European countries for dementia care. Alzheimer's disease and the many other forms of dementia have long been underrecognized and under-funded, leading to an urgent need for strong leadership and action to avert a crisis that could overwhelm the NHS and social care.
More specialists needed to achieve NICE standards
Authors: Goodwin Melesina
Published: May 2014

A new report on the provision of epilepsy services in England has been published by Epilepsy Action (2009) exposing significant deficits in the diagnosis, management and treatment of people with epilepsy. The report surveyed all acute trusts and primary care trusts (PCTs) in England and had a response rate of 54% from PCTs and 69% from acute trusts.
The ‘fit chart’, fit for purpose? A review of seizure chart documentation
Authors: Kuc Sue
Published: May 2014

Epilepsy is a disorder with a high misdiagnosis rate. This is partly due to the transient nature of the condition and difficulties obtaining detailed observational accounts from eyewitnesses to attacks. Nurses and medical staff involved in the acute care of patients admitted with seizures are ideally placed to record this important information. A small review of recording of acutely-presenting seizures in one district general hospital suggested wide variation in clinical practice, poor appreciation of the importance of seizure documentation, highlighted flaws in the design of the seizure charts in use, and raised questions about the staff's knowledge of how to describe epileptiform events. On the basis of these findings the seizure charts in use at this hospital were reviewed and redesigned in line with current standards, and a supportive educational programme for acute medical nursing staff was initiated.
Struggling with sleep
Authors: Winter George
Published: May 2014

These lyrics by Keith Richards offer unusual advice from a Rolling Stone who has only rarely allowed sleep's ‘forgetfulness divine’ to enshade his gloom-pleased eyes. According to Richards, his record for staying awake is around 9 days, but in a concession to his advancing years he recently admitted ‘Now I'll stay up for 2 or 3 days.’
Improving understanding of multiple sclerosis
Authors: Matthews Victoria
Published: May 2014

Multiple Sclerosis (MS) Awareness Week runs from 27 April to 3 May and provides a great opportunity to improve understanding of what it means to have MS. MS is a condition of a thousand faces, knows no boundaries, obeys few rules and brings challenges to all who are affected by a diagnosis.
The role of the hypothalamus, part 3: A key to the control of emotions and behaviour
Authors: Braine Mary E
Published: May 2014

The article explores the role of the hypothalamus in controlling emotions—in particular, pleasure, reward and aggression—and the neurotransmitters involved. Humans experience a great variety of emotions, and particular emotions can be described in many ways with subtle distinctions, for example, fear and trepidation, anger and rage, sadness and sorrow, pleasure and elation, calm and contentment, affection and love. Many distinct areas of the brain are implicated in emotions, and have been studied extensively over the years, leading to the notion that a neural circuitry is involved with key areas such as the amygdala, frontal cortex, limbic system and the hypothalamus. Some key historical researchers in this area and their discoveries are reviewed in this article, and some clinical presentations that relate to hypothalamic dysfunction are discussed. Finally, some areas for future research are identified.
Toward restraint-free care for people with dementia: Considering the evidence
Authors: Hughes Rhidian
Published: May 2014

Restraint, in its broadest terms, is the restriction of someone's freedom. In this exploration of the association between restraint and elder abuse, policy and practice issues are discussed with attention to people with dementia. It is emphasized that inappropriate restraint can violate human rights and these rights should remain unaffected when people use health and social care services. It is important to consider the underlying causes of people's behaviour that gives rise to the use of restraints. Education and training can help staff better manage difficult situations. There also needs to be adequate resources to ensure good quality health and social care for people with dementia.
Dystonia: The hidden movement disorder
Authors: Wells Val
Published: May 2014

Dystonia is an umbrella term covering a number of complex conditions affecting the eyes, face, neck, speech, limbs and trunk. It is a movement disorder characterized by involuntary and sustained muscle spasms and contractions that produce abnormal, twisting postures or repetitive movements. It can affect people of all ages, and there is currently no known cure. Dystonia can affect just one part of the body or several different areas. It is a neurological disorder affecting movement but not intellect. There are at least 40 000 people in the UK affected by the condition (Dystonia Society, 2009).
A wider choice of services for younger stroke sufferers
Authors: Gambrell Eileen
Published: May 2014

Different Strokes is a national charity launched in 1996 by, and for, younger stroke survivors to encourage active self-help and mutual support. It is still largely managed and staffed by younger stroke survivors and family members. It is estimated that 150 000 people have a stroke in England every year (Giles and Rothwell, 2007), and it is widely thought that incidence of stroke in the UK is under-reported and could be as high as 200 000 people each year. Immediate care for all stroke patients, especially early scanning and clot-busting drugs (where appropriate) reduces disabilities, mortality and morbidity
Approved provider scheme
Authors: Hassall Mandy
Published: May 2014

Headway—the brain injury association has received substantial funding from the Innovation, Excellence and Service Development Fund, to set up an accreditation service, which is intended to benefit its service users. Over the next 3 years Headway will be setting up an Approved Provider scheme—similar to the Preferred Provider scheme already provided by the MS Society for respite services in nursing and residential homes. The Headway scheme will differ slightly in that it will set standards for nursing homes, residential homes, transitional living units and those providing respite to someone that has sustained a brain injury.
Risking safety through impaired driving ability
Authors: McDonald Sheena
Published: May 2014

As ever, I've enjoyed my annual holiday in the United States—but not quite as much as in earlier years. I noticed that many drivers were using their mobile phones (known as cellphones in the US). This has been illegal back home since 2007. One still very occasionally sees British drivers risking the £60 spot fine and 3 penalty points, but in the States, drivers are customarily seen talking or texting on their cells. So are American drivers simply better at multitasking? Not according to people who work in the relevant medical fields. David E. Meyer, for instance, professor of psychology at the University of Michigan, was recently quoted in The New York Times (Richtel, 2009a):
Long-term invasive mechanical ventilation for patients with neurological impairments
Authors: Baker Mark , Kakora-Shiner Nicoline
Published: May 2014

Nursing patients with invasive mechanical ventilation who have neurological impairments requires skill across a range of physical, cognitive, psychosocial and communicative aspects of care. Drawing on the Roper, Logan and Tierney nursing model (1990), which focuses on patients as individuals, suggestions are made for best nursing practice for this patient population based on twelve activities of living, promoting independence with quality of life and essential functions of living.

Complications and long-term indications of invasive mechanical ventilation are also discussed and must be understood to guide patient care. The practice suggested in this article is not meant to be exhaustive—it is acknowledged that there may be further methods for delivery of high-quality nursing practice being undertaken in care homes and speciality services across the UK for this patient population. The paucity of literature on this nursing speciality is highlighted and this emphasizes the need to begin a discussion regarding complex neurological conditions and prolonged invasive mechanical ventilation for adults in long-term care settings.
Identifying and managing Tourette syndrome
Authors: Pountney David
Published: May 2014

Tourette syndrome, also known as Tourette's disorder or simply Tourette's, is a commonly inherited neurological movement disorder. Tourette syndrome is named after the French neurologist George Gilles de la Tourette, who first reported the condition in 1885 (Kenney et al, 2008). The disorder is defined as a chronic idiopathic syndrome with motor and vocal tics beginning before adulthood. Although Tourette syndrome is defined as part of a spectrum of tic disorders, Tourette syndrome is the most common cause of tics (Bloch, 2008). The disorder affects one child in every hundred and more than 300 000 children and adults in the UK. Research indicates that boys are affected two to four times more than girls (Rinder, 2007). The incidence peaks around pre-adolescence, with one half of cases resolving in early adulthood.
CORRESPONDENCE
Authors: Hassall Mandy
Published: May 2014

September diary: Networking in the neurosciences
New look Parkinson's charity to campaign for more specialist nurses
Authors: Phillips Joseph
Published: May 2014

The country's biggest Parkinson's disease charity rebrands itself as Parkinson's UK in April. The new identity brings with it the chance to refresh public interest and support, change attitudes and find a cure.
Doing more with less: Implications of the recession for health care
Authors: Hughes Rhidian
Published: May 2014

The latest UK recession began in the April–June quarter of 2008. It was the longest recession on record nationally. By January 2010 the UK was, technically, out of recession and, in the words of the Chancellor of the Exchequer, Alistair Darling, ‘we are on a path to recovery’. But, as the Chancellor qualified in an announcement on 26 January, ‘I'm confident but I'll always remain cautious’. Darling's note of caution is quite right, for as many commentators have indicated, this is an extremely lacklustre recovery (BBC, 2010). Germany and France, Europe's two largest economies, came out of recession during the summer of 2009, followed by the United States. The latest economic figures from the UK, however, show a much limited upward trend, and the risk remains that the economy could dip back into recession. The technical calculations remain with the Office for National Statistics which is expected to publish final figures in March 2010.
Meeting the board: Aims and achievements
Authors: Preece Anne , McCardle Kate
Published: May 2014

The British Association of Neuroscience Nurses (BANN) represents and promotes the interests of neuroscience nurses throughout the UK. Anne Preece, president of BANN introduces some of the executive board.
Caring for people with dementia on hospital wards
Authors: Chidgey Andrew
Published: May 2014

All nurses need to receive dementia training if the needs of people with dementia are to be met, and nurses supported in their role.
Research Roundup
Authors: Whitehead Bridget
Published: May 2014

Validation of the patient activation measure in a multiple sclerosis clinic
Early recognition of cognitive impairment in people with diabetes: role of primary care nurses
Authors: Pritchard Megan , Velayudhan Latha
Published: May 2014

Dementia is one of the commonest and most devastating diseases of later life. People with mild cognitive impairment and diabetes mellitus are reported to be at increased risk of developing dementia. In this article, the key role of primary care nurses in early recognition of memory problems in people with diabetes is emphasized. There is also a need for improving understanding of cognitive impairment. It is important that primary care nurses receive training in recognising impairment early
Improving relapse management in multiple sclerosis: a nurse-led model
Authors: Burgess Megan
Published: May 2014

An audit of services against the standards of the NICE clinical guidelines for multiple sclerosis (MS) (2003) highlighted that the MS relapse service in Greater Manchester was not NICE compliant and did not meet the requirements highlighted in published best practice. The service was remodelled and a dedicated relapse clinic led by the MS nurse consultant was established. A further audit was conducted and the remodelled service was found to be meeting the required standards. The results of this audit and the implications for managing relapse in MS in this way are discussed.