bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical performance of a hydrogel dressing in chronic wounds: a prospective observational study
Authors: Zoellner P. , Kapp H. , Smola H. 
Published: May 2014

Objective: This prospective, multicentre application study was conducted to assess the clinical performance of Hydrosorb comfort hydrogel dressing. Method: Eighty-one patients (average age 67 years) with acute or chronic wounds received three dressing changes. The condition of the wound and patient-reported pain were assessed at the beginning and end of the study period. Results: The mean proportion of the wound surface covered with slough fell from 63% to 34%, and the mean area of new granulation and epithelial tissue increased from 25% to 37% and 13% to 28%, respectively. The average wound size decreased from 4.7 x 2.9cm to 3.7 x 2.3cm; 29.6% of the patients reported no pain at baseline, increasing to 56.3% at the final assessment. Conclusion: Both acute and chronic wounds can be effectively treated with the Hydrosorb comfort hydrogel dressing. Declaration of interest: This study was sponsored by Paul Hartmann Ag, Heidenheim, Germany.
Does liquid tissue adhesive increase satisfaction with wound and stoma management after
Authors: Aslam M.I. , Hunter D.C. 
Published: May 2014

Objective: This pilot study reviews the impact of tissue adhesive to seal skin wounds in elective large bowel resections where a stoma is fashioned. Method: Patients undergoing elective colorectal resection over six-month period were prospectively evaluated for wound infections rates, length of inpatient stay and patient satisfaction with their wound and stoma management. The wounds were observed for 30 days in both inpatient and outpatient settings. A patient satisfaction questionnaire was used with respect to the stoma and wound management. Results: Fifty patients undergoing elective colorectal resection over a six-month period were prospectively evaluated. The median patient ages were 63.5 years (40–83) for males and 60 years (33–85) for females. Ninety-two per cent of the patients found their wound management satisfactory (overall satisfaction score >5, where 5 represents ‘high satisfaction’). Eighty-six per cent reported a stoma management satisfaction score of >4 (where for 4 represents ‘satisfaction’). Stoma site leakage was reported by 16%, but none of these developed a SSI. Two patients who had laboratory-confirmed SSI; they had an average length of inpatient stay of 18 days compared with 6.5 days for patients without SSI. Conclusion: Liquid tissue adhesive provides a flexible, water-resistant and protective coating which increases the satisfaction and ease of surgical wound and stoma management. We recommend a randomised controlled trial be conducted to evaluate these results in larger cohorts. Declaration of interest: None.
Comparison of the interface pressure and stiffness of four types of compression systems
Authors: Wong I.K.Y. , Man M.B.L. , Chan O.S.H. , Siu F.C. , Abel M. , Andriessen A. 
Published: May 2014

Objective: To compare interface pressure (IP) and static stiffness index (SSI) of four different compression systems currently in use for the treatment of patients with venous leg ulcer. Method: Fifty-two ambulatory adults with healthy legs were recruited at random at a study centre after they had consented. The evaluated systems were: short-stretch system (SSB), Rosidal sys (Lohmann & Rauscher), multilayer bandaging (LSB) Profore (Smith & Nephew), Vari-stretch (VSB) ProGuide (Smith & Nephew) and tubular compression (CS) Rosidal Mobil (Lohmann & Rauscher). Interface pressure was measured using Kikuhime (Harada Corp.), placing a 3cm-diameter probe at the B1 point. IP recording took place in the supine and standing positions, while sitting and during walking, on application of the compression systems and every 15 minutes thereafter for 4 hours. Results: The IPs of SSB, LSB and VSB, measured immediately after bandage application, were significantly higher than that of CS (all p < 0.05). During the 4-hour study period, the IP for both VSB and LSB measured in the supine position initially increased to > 60mmHg. Their overall mean IPs in the supine position were 48.96 ± 3.99mmHg and 48.12 ± 4.57mmHg, respectively. SSB and CS demonstrated more tolerable IP levels in this position of < 40mmHg, which was similar to those when sitting. All systems maintained at least 40mmHg in walking. SSB had a high SSI of 20 throughout the study. LSB followed with an SSI of 18 at the start, which reduced to 13, while the SSI for VSB decreased from 17 to 12 and CS, with an SSI of 6, lagged behind. Conclusion: These results may contribute to the understanding of IP and SSI of the four different compression systems evaluated. The IP and SSI data presented give clinicians an indication of the appropriate frequency of re-application of compression, and preliminary data on choosing a safe and effective compression treatment for their patients. Declaration of interest: The investigators received an educational grant from Lohmann & Rauscher GmbH & Co KG for this study.
Characterisation of epidermal regeneration in vivo: a 60-day follow-up study
Authors: Kottner J. , Hillmann K. , Fimmel S. , Seite S. , Blume-Peytavi U. 
Published: May 2014

• Objective:To characterise the long-term course of epidermal regeneration in a suction-blister wound model in healthy humans. • Method:A single-centre, prospective cohort study was conducted. Suction blister wounds of 8mm diameter were created on the volar forearms of healthy volunteers. Planimetry was used to measure the wound surface area. tansepidermal water loss was estimated to characterise the skin barrier function. skin brightness was measured using the chromametric luminance L* parameter and skin (visco) elastic properties were measured by a controlled suction device. • Results:Thirty-two subjects (mean age 28.6 years) participated. Epithelisation was nearly completed after 8 days, but it took approximately 3 weeks for complete skin barrier restoration. Post-inflammatory hyperpigmentation was observed at the end of day 60 in the majority of skin areas. Elastic and viscoelastic deformation and recovery at the end of the follow-up period did not reach baseline values. • Conclusion:Newly formed epidermis requires considerable time before reaching complete recovery of the skin barrier function. Up to 2 months after the injury, regenerated epidermis in junction with the reticular dermis is stiffer compared to before. Under mechanical loading increased local stiffness might increase the risk for subsequent injuries at the same or adjacent skin areas. Due to its increased vulnerability it is recommended to protect or to offload the epidermal tissue as long as possible to support the structural long-term regeneration. Artificial suction blister wounds are well standardised and controlled models for a wide range of clinical studies and they offer advantages over uncontrolled patient conditions in wound healing studies. • Declaration of interest:This study was funded by la Roche-Posay Laboratoire Pharmaceutique (Asnieres, France). The sponsor had no influence on the design, conduct, and analysis and presentation of the data and on the content of this manuscript. The authors have no financial interest in this article.
Normal labour and birth
Authors: Lingen-Stallard Andrew 
Published: May 2014

Normal birth is a common outcome for the ambulance service following an imminent birth dispatch. In 2008, the London Ambulance Service attended over 1000 imminent births calls, with the crew either in attendance for a birth, transporting prior to birth or the infant born before arrival of a crew. The majority were full-term, low risk pregnancies with a normal birth, and the mother having birthed previously (personal communication, London Ambulance Service, 2009). The aim of this paper is to review the issues of normal birth. It will explore the concept of normal birth and encourage practitioners to reflect on care after a normal birth. It discusses the physiology and mechanism of normal labour, birth and physiological placental expulsion. The paper will explore the ambulance clinician's role in securing and maintaining a normal birth outcome and explore care required for the woman, newborn infant and family. This paper will not discuss complications in pregnancy and during labour or in depth discuss birth, postnatal complications or newborn resuscitation. Ambulance personnel must follow the guidelines issued by the Joint Royal Colleges Ambulance Liaison Committee UK Ambulance Service Clinical Practice Guidelines (2006) (JRCALC, 2006).
The need for paramedics to be able to identify cauda equina syndrome
Authors: Nellist Emily , Lethbridge Kris 
Published: May 2014

Cauda equina syndrome (CES) is a rare but serious neurological emergency, which may require urgent neurosurgical intervention. If left untreated it can lead to devastating consequences of paraplegia with bladder or bowel sphincter deficits. It is the experience of the authors that this is a condition that pre-hospital clinicians may encounter but does not currently feature in all paramedic education curricula. This article looks at what the cauda equina is and how CES can occur. It describes the common signs and symptoms as well as identifying those which should be considered as red flags in practice. After also considering the medico-legal aspects associated with the incorrect or delayed diagnosis of cauda equina syndrome, the authors will recommend that this condition should feature on the future curriculum of all paramedic education and should be a differential diagnosis, considered whenever a clinician assesses a patient with back pain, especially of a non-traumatic nature.
Physiology and effects of the menopause
Authors: Brockie Jan 
Published: May 2014

The menopause, caused by ovarian failure, is natural part of female ageing. Most women will experience a spontaneous menopause around 52 years in the western world. Some women become menopausal because of surgical removal of their ovaries or as a result of treatment for other disease such as chemotherapy or radiotherapy. A menopause before the age of 45 years is considered premature and these women may need closer supervised care and support. Women often report changes in menstrual pattern and a woman is considered postmenopausal following 1 year of amenorrhoea. Checking follicle-stimulating hormone levels can sometimes be helpful to confirm diagnosis in women following hysterectomy or with unexplained amenorrhoea. Each woman has a unique and individual menopause experience. Many women experience vasomotor symptoms and sometimes psychological symptoms in the perimenopause and in a minority of women, these can continue for many years. With the increase in female life expectancy over the past century, the long term consequences of the menopause, such as cardiovascular disease and osteoporosis, are significant because of the distress and dependence to ageing women and the resulting burden on the social and health services.
Management of functional constipation in childhood
Authors: Rogers June 
Published: May 2014

Functional constipation is a common childhood condition. In the majority of cases the constipation develops as a result of a complex weave of factors including specifi c triggers, such the passage of large painful stools, which then perpetuates the problem when the child begins to associate pain with defecation. The management of constipation can often be a challenge in children, who initially may be reluctant to sit on the toilet. This article will discuss the keys to successful treatment, including ensuring an holistic, child-focused approach with effective initial evacuation and appropriate maintenance therapy.
Legal and ethical implications of non-medical prescribing
Authors: Lovatt Penny 
Published: May 2014

The nurse independent prescriber (NIP) role has slowly evolved over 6 years, since its introduction in 2000 in line with the Government plans to modernize the NHS. The development of this role served to benefit the patients by improving access to medication, empowering them to have a degree of choice in their health care and the staff in extending their scope of practice and professional development. Accordingly there are numerous professional, ethical and legal implications associated with this extended nursing role. The article will consider both the professional accountability and the legal issues involved in NIP, before discussing how the ethical principles of beneficence, non-maleficence, autonomy and justice underpin safe, cost effective prescribing practice. In considering how ethically, legally and morally sound NIP fits into the clinical setting, application of the discussion in introducing this role into a minor Injuries unit is included.
Nurse independent prescribers' views on recent medicine switches
Authors: Rutter Paul M , Tsang Glen 
Published: May 2014

Background: Current UK health policy advocates the concept of self-care and encourages patients to take greater ownership of their own health. One enabler of self-care is to provide patients with more opportunities to treat and manage conditions without consultation with a prescriber. The continued movement of medicines to non-prescription status is one way in which this can be achieved. The principal research objective of this study was to ascertain how receptive nurse independent prescribers (NIPs) were to medicine deregulation. Methods: A self-administered survey, primarily consisting of 5-point Likert scales (strongly agree to strongly disagree) was distributed to all known NIPs currently working in the East and West Midlands Strategic Health Authorities. Results: Fifty replies were received, yielding a response rate of 39%. The vast majority of respondents agreed that deregulation of medicines would allow patients easier and quicker access to treatment, and help in reducing their own workloads. NIPs were supportive of recent and proposed medicine switches involving the management of acute problems (e.g. omeprazole, naproxen and trimethoprim), but much more reserved in seeing medicines for chronic conditions available over the counter. Reservations centred on pharmacists not having sufficient time or resource, for example an inability to provide appropriate monitoring. With increased deregulation, NIPs had concerns over medicines being inappropriately used, resulting in patient safety being compromised. Conclusions: NIPs were positive toward greater medicine availability to treat acute self-limiting conditions, but were more circumspect when considering the management of chronic conditions via over-the-counter medicine supply.
Cardiovascular Forum
Authors: Greener Mark , Linssen Rebecca , MacGregor Graham , Beevers Gareth , Kooner Jaspal S , Reckless John , Dodson Paul , McInnes Gordon , Pickup Tony , Poulter Neil 
Published: May 2014

Introduction How practice nurses can tackle the hyertension epidemic Salt: old or new villain? Ethnic differences in cardiovascular disease: focus on Afro-Caribbeans Ethnic: differences in cardiovascular disease: focus on Asians Cardiovascular disease and cholesterol guidlines: can the UK aford them? A revolution in diabetic care? AT1 receptor blockers: an overview Experience with valsartan Health Survey for England: the state of hypertension managment
Clinical Audit And The Practice Nurse
Authors: Fox Julia 
Published: May 2014

Most nurses are already familiar with the evaluation of their interventions through the ‘nursing process’. Very little is known about the level of nurses' involvement in clinical audit within primary health care and this paper describes how the audit experience of Avon's primary care nurses was explored and identifies how further involvement might be facilitated. A questionnaire was sent to practice-based nurses in Avon. Over half of respondents (55%) were currently involved with the audit of patient care within their own practices. The respondents were predominantly involved in data collection although awareness of the need to be involved in the full cycle was certainly evident. Initiation of audit was thought to be the responsibilty of the whole primary health care team by almost half of the respondents (46%) and should be routine for 37%. Over half (57%) had been able to demonstrate improvements in patient care as a result of audit with benefits for both patient and practice. A lack of knowledge about the process of audit and a lack of evidence that audit can improve patient care were among the main factors affecting involvement in audit. As a result of audit many improvements in patient care have been demonstrated. Nurses need further training to enable them to effectively carry out audit and implement change. If audit is to be accepted it should be relevant to practice, patient-centred, and should be able to demonstrate improved care.
The management of obesity in primary care: a pilot study
Authors: Saeidi Saeideh , Johnson Mark , Sahota Pinki 
Published: May 2014

Background: Obesity is recognized as a global public health issue, with prevalence in the UK increasing sharply during the 1990s and early 2000s. The National Institute for Health and Care Excellence (2006 ) recommends that ‘managers and health professionals in all primary care settings should ensure that preventing and managing obesity is a priority, at both strategic and delivery levels’. The aim of this study was to develop and evaluate a facilitated self-help weight-management intervention for obese adults attending general practice. Method: A two-phased study was used. Phase 1 developed a facilitated self-help weight-management intervention, and phase 2 delivered and evaluated the 6-month intervention using a pre- and post-test design. Semi-structured interviews and focus groups were used in phase 1. Measurements of height, weight and waist circumference were taken during phase 2. Nurse interviews and patient questionnaires were used to evaluate the quality and acceptability of the results obtained. Results: The intervention was successful in attaining statistically significant reductions in mean weight of 4.20 kg (95% CI 2.43, 5.97), in mean BMI of 1.52 kg/m2 (95% CI 0.88, 2.16) and in mean waist circumference of 4.66 cm (95% CI 2.38, 6.94) at post-intervention. Patients reported that they valued regular contact with the practice nurse, and that increased knowledge about healthy eating and the educational material provided had facilitated behavioural change. Practice nurses felt the intervention was easy to implement and relevant to primary care. The monthly supervision meetings were valuable and provided an opportunity for the nurses to reflect on practice and discuss new ideas. Conclusions: The intervention was effective and practice nurses attending a short training course followed by minimum supervision were able to successfully deliver the programme.
How to create a rabbit friendly practice and run a successful rabbit clinic
Authors: Brash MGI , Stanton DM 
Published: May 2014

The development of rabbit clinics ensures that when rabbits are taken to a veterinary practice, they receive a high level of service and their owners are given good quality information. This increases the clients' confidence in the veterinary practice, as well as their ability to look after their pet rabbit — a practice can soon become known for its ability to look after rabbits well. It is time for veterinary practices to move away from, ‘it's only a rabbit!’, and to deliver the same high standards of care and treatment that are given to cats and dogs. This article provides a step by step guide on how to run a successful rabbit clinic.
Chemotherapy: toxins and barriers
Authors: Roberts Linda 
Published: May 2014

There are many instances in which the cancer patient and its nursing staff may be exposed to toxins and/or require barriers. Although the beneficial effects of chemotherapy against the cancer generally outweigh the potential side effects in skilled hands, almost all anticancer drugs have side effects. Toxicity is the most significant treatment-limiting factor in cytotoxic drug use. In addition, multiple studies have shown multiple potential dangers to staff handling cytotoxic drugs, including increased chromosomal alterations, hepatotoxicity and abnormal reproductive outcomes to be associated with exposure to various chemotherapeutic drugs. For these reasons, it is important that written safety protocols be established and followed in the any veterinary clinic administering chemotherapy. There must also be written instructions to pet owners for at-home administration, handling of drugs and for dealing with drug-contaminated excreta. Veterinary nurses have a vital role to play in the care of chemotherapy patients, and in maintaining the health and safety of both patient and staff. Careful administration of cytotoxics and subsequent patient monitoring should avoid many potential complications of using these drugs. If guidelines are followed, the safe use of cyto-toxic drugs should be possible for the majority of veterinary practices, with minimal risk to all staff involved. Practices and personnel should not become complacent with cytotoxic drug use and regular risk assessment, and updates to Control of Substances Hazardous to Health (COSHH) local rules.
Flora da Bahia: Boodleaceae
Authors: Alves Aigara Miranda , Gestinari Lísia Mônica de Souza , Moura Carlos Wallace do Nascimento 
Published: May 2014

A survey of Boodleaceae from the coast of Bahia State, Brazil, is presented as a contribution to the knowledge of the chlorophytes. Three genera and four species were recognized: Boodlea composita, Cladophoropsis membranacea, Phyllodictyon anastomosans and P. pulcherrimum. An identification key, descriptions, illustrations and comments on taxa as well as distribution maps for the species in Bahia State are presented.
Historicising “Law” as a Language of Progress and Its Anomalies: The Case of Penal Law Reforms in Colonial India
Authors: Shahabuddin Mohammad 
Published: May 2014

AbstractThis paper dispels the myth of liberal Enlightenment in relation to penal law reforms in colonial India by advancing two sets of argument. First, the liberal project of codification on the basis of universalist notion of utilitarianism never broke with cultural hierarchy inbuilt in the very act of colonisation. In this paper, I specifically look into the emerging phenomenon of evolutionary science in the nineteenth century – social Darwinism – to explain the dominant normative, as opposed to realist, justification of such racial hierarchy in colonial discourses since the nineteenth century. Second, using Dipesh Chakrabarty’s theoretical framework, I provincialise the penal law reform project in colonial India through the examination of literature in the field, and substantiate how the notion of utilitarian universality remained vague and unpromising in face of instrumental needs on ground – both in the colony and in the metropolis. Taken together, these propositions dispel the myth of the liberal project of penal law reforms in colonial India based on this universalist position and underscore the fallacies of the transition narrative of modernity itself.
Changes in phytoplankton community composition along a salinity gradient from the lower Yenisei River to the Kara Sea, Russia
Authors: Bessudova Anna Yu. , Sorokovikova Larisa M. , Firsova Alena D. , Kuz’mina Anna Ye. , Tomberg Irina V. , Likhoshway Yelena V. 
Published: May 2014

Abstract
Changes in phytoplankton community composition related to salinity, allochthonous matter, and nutrients were found in the mixing zone that extended from the outflow of the lower Yenisei River into the Yenisei Gulf and Kara Sea in Russia. The highest cell abundance (140–662×103 cells m-3), biomass (138–950 mg m-3) and species diversity were found in the freshwater area (i.e., the lower reaches of the Yenisei River). The river-sea transition was marked by a decrease in the relative abundance of green algae and cyanobacteria, but an increase in chrysophyte algae. The ratio of freshwater and marine phytoplankton species was quantified in each habitat. The results contribute to our understanding of biological processes in the estuaries of large rivers flowing into the shelf zone of the Arctic Ocean.