bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a website for multiple sclerosis: Involving service users and providers
Authors: Burgess Megan 
Published: May 2014

The Greater Manchester Multiple Sclerosis Management Audit was carried out in 2006 by Taylor and Walton to compare the management of multiple sclerosis (MS) in Greater Manchester against national recommendations for the management of MS set down by NICE (National Collaborating Centre for Chronic Conditions, 2004). This audit revealed that MS services in Greater Manchester were only partially compliant with the standards defined in this audit, which were derived from the NICE guidelines. Discussion within the MS Clinical Governance Group resulted in a proposal for a website to supply information about local services. This article discusses the development of the website with reference to the relevant audit results and the standards defined in the audit for information giving. It was identified at an early stage that service user involvement would be essential to the success of the website project. A period of consultation by MS Society branches was led by volunteers, followed by an email consultation of the health and social care professionals via the MS Special Interest Group. The website content was then agreed and compiled and the website went live in December 2007. The website gives details of local MS services as well as information about events and courses for people affected by MS, details of research trials and links to other relevant websites. A summary of service user and service provider feedback is included alongside quantitative data relating to the use of the website since going live.
Making a difference in Parkinson's disease: An audit of patient perspectives
Authors: Reading Sharon , McGee Patricia , Brechany Una 
Published: May 2014

Parkinson's disease (PD) affects approximately 120 000 people in the UK with an age range from people in their 30s upwards. The classic signs of PD are slowness and poverty of movement, tremor and rigidity. Patients experience motor and non-motor complications and some papers suggest up to 80% of patients may go on to develop dementia. PD is a chronic progressive illness with no known cure. Treatment is based on individual need as there is much variation in symptoms. Three years ago, National Institute for Health and Clinical Excellence (NICE) guidelines for the care of people with Parkinson's were published (2006). However, two leading charities have recently completed surveys which show that large numbers of patients remain unhappy with the overall care they receive. In Newcastle, a team of Parkinson's disease nurse specialists conducted an audit of the service they provide. The main aims were to survey the quality of the service from the patients' perspective and to provide a model for future development based on the findings. The key tool was a patient satisfaction survey of 300 people attending the outpatient clinics. From 209 completed questionnaires, only two patients reported overall dissatisfaction. This article looks at the areas that patients found particularly helpful such as daily telephone advice lines and home visits and those where there was room for improvement such as access to information.
The ills of the profession and search for a cure
Authors: Chesney Margaret 
Published: May 2014

It is with the heart that one sees rightly: what is essential is invisible to the eye (Antoine Dc Saint Exupery, The Little Prince). The ills of the profession are indeed visible to the eye. I read of midwifery education being in crisis (Henderson, 1997) and listen daily to teachers who feel out of control in the shifting sands of higher education.
Midwifery in Scotland 1 – the legislative background
Authors: Reid Lindsay 
Published: May 2014

This article is the first in a series of four examining midwifery in Scotland from 1916 to 1983 when the Central Midwives Board for Scotland (CMB(S)) oversaw midwives' education and practice. It gives an overview of important midwifery legislation in Scotland from the 1915 Midwives (Scotland) Act to the implementation, in 1983, of the 1979 Nurses, Midwives and Health Visitors Act. Legislatory provision, while giving midwives a legal identity, also affected their autonomy (Fleming, 1998). During the period under examination, midwives' ability to be autonomous practitioners fluctuated within the frameworks which regulated their education and practice.
Bullying in the workplace: What it is and how to deal with it
Authors: Keeling June , Quigley Jane , Roberts Tim 
Published: May 2014

Bullying in the workplace is a common phenomenon which not only impacts on a midwife's quality of life but also her professional remit. Research has demonstrated that it is often the supervisor of midwives or line manager who is the bully. The midwife may find the situation untenable resulting in leaving the profession or changing jobs. This article highlights bullying behaviours and describes the detrimental effect that this deviant behaviour has on victims. The organizational and professional responsibilities are addressed and details are given about where a victim can access help and support.
Homeopathy as a choice: the new holistic antenatal clinic
Authors: Baxter Jacqueline , Perrin Chris 
Published: May 2014

Increasing numbers of pregnant women are turning to homeopathy and other complementary therapies to help with pregnancy and childbirth. In response to this, a programme was put together to provide safe education and treatment by a multidisciplinary team of professionals. Working collaboratively, a multidisciplinary group of midwives and staff from two departments within a large NHS Trust have set up this innovative new service. This paper describes a pilot scheme to introduce homeopathy and other complementary therapies into mainstream care provision. Pregnant women can attend the new clinic for their routine follow up antenatal checks and at the same time experience a parent education session initially including homeopathy, stress management and relaxation, and also nutrition for mother and baby.
Planning and implementing mental health training
Authors: Ross-Davie Mary , Elliott Sandra , Green Lucinda 
Published: May 2014

This article describes the development of a training day for maternity professionals on perinatal mental health. The need for such ongoing training has been highlighted by the Confidential Enquiries into Maternal Deaths. Death from psychiatric causes has been the leading cause of maternal death for the last two Triennia. The aims of the training programme are to improve the detection of women with current mental health problems and those at high risk of a serious mental illness following delivery in order to improve the care and support offered to them throughout their contact with maternity services. The training day aims to facilitate improvements in knowledge, attitudes and skills of midwives and obstetricians in relation to mental health. The article sets out the programme for the day and the lessons learned by the team providing the training to assist others who are hoping to develop perinatal mental health training programmes in their area.
Antenatal assessment for risk of venous thromboembolism
Authors: Whapshott Helen C 
Published: May 2014

Thromboembolic complications during pregnancy are the highest cause of maternal death but there is a lack of risk assessment tools designed to estimate the degree of risk for individual women. The aim of this study was to create a risk assessment tool using the available evidence from the literature which could be used by community midwives at the antenatal booking interview to assess a woman's degree of risk for venous thromboembolism in pregnancy. A comprehensive literature review was carried out to evaluate the literature and calculate degrees of risk. Further development of the risk assessment tool will enable midwives to assess women for their degree of risk for developing venous thromboembolism after delivery or if they are admitted to hospital during the course of their pregnancy.
The modified WHO partograph: do we need a latent phase?
Authors: Kwast Barbara E. , Poovan Pia , Vera Edita , Kohls Elaine 
Published: May 2014

The objective was to study the frequency and mode of delivery of women admitted in the latent and active phase of labour in St. Luke's Catholic Hospital in Wolisso, Southwest Shoa Zone, Oromia Regional State, Ethiopia. It was a descriptive, retrospective design. Admission phases of labour and mode of delivery were collected for seven months. The modified World Health Organization (WHO) partograph was introduced in Wolisso in January 2007. Analysis of mode of delivery of women admitted in the latent and active phase, showed that women admitted in the latent phase had more operative (both abdominal and vaginal) deliveries as labour progressed to the right of the alert line in active phase compared to women admitted in the active phase of labour. Partographs were generally plotted very well, with 86% of those eligible for partography available for analysis. Application of the management protocol needs to improve as the average monthly C/S rate is 22.5% and augmentation of labour is rarely applied. It is recommended that a management protocol for women admitted in the latent phase is formulated and applied. Space for these women needs to be organized closer to the labour ward for regular observation in the latent phase and earlier diagnosis of the onset of the active phase of labour.Considering the mean number of 5.857 hours until the active phase was diagnosed, re-introduction of the latent phase on the WHO partograph remains a controversial subject. However, development of, and adherence to, a management protocol for these women is strongly recommended. One-third of the women were admitted in the second stage of labour which means that frequency of partograph use should not be used as a quality of care indicator in management information
Milk production during pregnancy and beyond
Authors: Hilton Sioned 
Published: May 2014

The following article will discuss the basic physiology of breast development during pregnancy, the production of milk and hormones involved and the relationship between supply and demand during this time. It also touches on breast milk composition, the changes it goes through following birth and the problems faced by some women as their bodies adjust to motherhood. The article will introduce the challenges faced by new mothers especially during the transition from feeding in the early days to learning to manage feeding when they become more independent. It offers suggestions on how midwives can support these women. The article also discusses various methods of expressing and presents a guide to help encourage and support new mothers to feed. This is a vital process to be managed following birth which can greatly affect a newborn's development and if problems occur they must be dealt with immediately.
Leadership theories relevant to the role of the supervisor of midwives
Authors: Hinchliffe Julie 
Published: May 2014

The beginning of the 21st century has seen the importance of strong clinical leadership, at all levels of the NHS, with the result that the quality of care and the safety of services can be improved (King's Fund, 2007; Department of Health, 2008a). Supervisors of midwives (SOMs) are well placed to provide leadership within the maternity services. The focus of this article is to explore the leadership component of the role of the SOM, and analyse it in relation to leadership strategies and theories, while acknowledging its impact on the quality of care and the reduction of risk that it generates. Various leadership techniques and models will be offered that can be used by the SOM to execute their leadership role more effectively. Transformational, situational and action-centred leadership is discussed alongside emotional intelligence, and the influence that a group of supervisors can have within an organization.
Nipple confusion in neonates
Authors: Hargreaves Kelda , Harris Anna 
Published: May 2014

Breastfeeding is influenced by social factors, some of which motivate women to seek additional feeding solutions, including feeding formula milk or expressed breastmilk (EBM) by bottle. Anecdotal evidence indicates that some women offer bottles of EBM during and after the establishment of breastfeeding and continue to breastfeed successfully. The World Health Organization (WHO) recommends that breastfed infants should not be offered artificial teats during the establishment of breastfeeding. This is due to concerns regarding nipple confusion. This article confirms that the evidence supporting nipple confusion is inconclusive and that other issues such as supplementation with formula milk can lead to problems labelled as nipple confusion. Breastfeeding advice advocated by WHO may not meet the needs of all breastfeeding women and prescriptive advice from health care professionals may lead to early cessation of breastfeeding which is avoidable. Midwives should be flexible in their approach to breastfeeding and take women's individual needs into account.
Routine vaginal examination to check for a nuchal cord
Authors: Jefford Elaine , Fahy Kathleen , Sundin Deborah 
Published: May 2014

Many midwives routinely perform a vaginal examination during birth to check for the nuchal cord. Such an invasive procedure would only be consistent with midwifery philosophy if it was common to find a nuchal cord so tight that the only alternative is to cut in order to allow the birth of the baby. A tight nuchal cord, however, seems to be rare. So how did it happen that the invasive procedure of checking for the nuchal cord vaginally became a ritualized practice in contemporary midwifery? The historical literature on the significance of finding a nuchal cord is reviewed in this article. Checking for the nuchal cord has been advocated by medical textbooks. The call to make this procedure routine for all women was not made in medical texts until the late 17th century onwards. Though an exploration of the historical origins of the procedure it is demonstrated that the arguments used act as a model for the way in which all aspects of birth have been medicalized through fear. It is hypothesized that when the midwife avoids routine invasive checking for the cord and instead makes individual clinical decisions for each particular woman and baby this may be a marker of her willingness to practice as an autonomous decision maker and not just of follower of ritual.
Computers and CTGs: where are we at?
Authors: S Barber Vicki , Lean Katie A , Shakeshaft Clare E 
Published: May 2014

The latest National Institute for Health and Clinical Excellence guidelines on intrapartum care include advice on the appropriate use of cardiotocographs. This technology has become, rightly or wrongly, commonplace as an increasing number of women are receiving CTG monitoring during their labour. The technology is now over 50 years old, however, it has still to be proven effective. The cardiotocograph monitors are not monitors per se—they are used as a recorder and signal display to be then reviewed by an observer. Increasingly computers have been used to improve this technology, both display and interpretation and computers are now to be used to help interpret traces in real time. This article addresses whether the potential in CTG monitoring technology has finally materialized.
Modern simulation-based training in obstetrics
Authors: Wedisinghe Lilantha 
Published: May 2014

Dear Editor Management of obstetric emergencies is difficult. Managing a rarely occurring obstetric emergency would be challenging, even for a very experienced accoucheur. This highlights the importance of obstetric emergency management courses. In most of these courses, for example, advanced life support in obstetrics (ALSO) and managing obstetric emergencies and trauma (MOET), simulation-based training is provided. Such training with the use of novel simulators appears very productive and perhaps, ideal.
Presentation and management of eczema in children
Authors: Watkins Jean 
Published: May 2014

Eczema is a common skin condition, which can have a serious impact on children and young people's wellbeing. It is therefore important that school nurses are able to support pupils with the condition and offer appropriate advice to them and their family. This article provides an overview of eczema in children and young people, including the potential impact of the atopic and contact eczema, presentation, complications and management.
Developing a self-evaluation form for patients with long-term mental illness
Authors: Salo-Chydenius Sisko 
Published: May 2014

The accurate assessment of occupational functioning is one of the most difficult areas of occupational therapy. There is a strong need for reliable and valid instruments. The translation of measuring instruments is one option, but there are problems that impact on this, e.g. language and meaning, culture, values and social customs. New instruments for occupational therapy should be developed which take into account the sociocultural context. The instrument should be based on clinical needs and should help an occupational therapist to strengthen his/her work in the hospital or the community. The self-evaluation of the activities of daily living for a patient with long-term mental illness (Salo-Chydenius, 1996b) is underpinned by cognitive–behavioural theories. This article looks at the development of an instrument for patient self-evaluation, and evaluates and compares it to standardized English instruments such as Liberman et al (1989), Birchwood and Tarrier (1992) and Bellack et al (1997). This instrument is still at the developmental stage, and further work is required to assess its reliability and validity.
The foundation degree: an education framework for rehabilitation assistants?
Authors: Priestley Jane , Selfe James 
Published: May 2014

A major feature of foundation degrees, which were introduced as a new development in February 2000, is the high proportion of work-based learning and the concept of ‘earn and learn’. Concurrent with this development was the increasing acknowledgement of the need to provide more flexible education for the NHS workforce. A key feature of the development of foundation degrees was employer involvement in the design and delivery of the programmes, which provided an ideal opportunity to develop a health-care programme that met service needs. Bradford University was successful in obtaining funding to develop a foundation degree in health and social care as part of the pilot phase. One particular pathway of this programme was aimed at meeting the needs of rehabilitation assistants. This article describes how the course meets the demands of the modernization agenda and outlines the challenges faced and future developments. Developments are focussed on short course provision for rehabilitation assistants and a certificate in rehabilitation within the foundation degree framework. Additional support for the transition to learning in the University setting will be offered as part of this provision, to promote access to higher education for this valuable sector of the workforce.
Non-invasive measurements of scoliosis and the spine: a review of the literature
Authors: Chockalingam Nachiappan , Dangerfield Peter 
Published: May 2014

Adolescent idiopathic scoliosis frequently develops around puberty and involves both translational and angular asymmetry of the rib cage and back surface vertebrae. This article examines various invasive methods used to measure the spine and back and reviews research on non-invasive measurement systems. This should allow clinicians and therapists with an interest in the spine and back to be informed of the different approaches undertaken for clinical evaluation and research in this field. Optoelectronic gait analysis systems have been used to measure dynamic back movements, but there remains need to optimize marker placement procedures. The importance of trunk movement in human gait has been established in many studies, although quantifying spinal deformities and the range of spine and trunk movement has concentrated on the static position of the body. Additionally, there is paucity of data detailing the actual relative motion between the back and lower limb during gait. This article highlights the need for quantitative information examining the relationship between load and the spinal curve.
Meeting the information needs of people with multiple sclerosis
Authors: Slade Anita , Tennant Alan , Ford Helen 
Published: May 2014

A health needs assessment of people with multiple sclerosis (MS) in Leeds identified the need for information as a priority. An information pack was developed using focus groups and individual interviews undertaken with people with MS, carers and health-care professionals. A second group of people with MS participated in a 6-month evaluation, recording symptoms, quality of life and health status at baseline and follow-up. Usage of the information pack and its suitability was recorded. Fatigue and muscle stiffness were the most commonly reported symptoms (79%). Although quality of life was relatively good at baseline, the progressive group became worse (P <0.05) at follow-up. Participants experiencing problems were more likely to use the information, but the pack was thought to be useful by all participants. Consensus as to when it should be given to the newly diagnosed could not be reached.
Stroke community rehabilitation: a classification of four different types of service
Authors: Geddes Joanna , Chamberlain M Anne 
Published: May 2014

In the past two decades a great variety of community rehabilitation projects and teams have been developed, which are not easy to classify. This study examined the usefulness of a proposed classification system for home-based rehabilitation services for people with stroke. It was descriptive, comparative and quantitative. Services were categorized into four types: early supported discharge rehabilitation; postdischarge community rehabilitation; GP-orientated community rehabilitation; and late community rehabilitation. The features of each are described. The rehabilitation of almost all (98%) of patients studied could be placed within these categories. Providers of services, such as primary care trusts, need to identify the needs of their service users and match them, if possible, to suitable provision.
Likelihood of drop out during a graded exercise test in non-psychotic psychiatric patients
Authors: Knapen J , David A , Van Gool M , Van de Vilet P , Van Coppenolle H , Peuskens J , Knapen K 
Published: May 2014

This article investigated the drop out during a graded exercise test (GXT) in 124 non-psychotic psychiatric inpatients. The severity of depression and anxiety and level of physical activity, physical selfworth and motivation towards psychomotor therapy were assessed by means of questionnaires. A stepwise logistic regression equation was used to ascertain the determining variables for drop out. In total, 50 patients (40.3%) were unable to complete the GXT to 80% of the estimated maximal heart rate reserve. The determining variables for drop out, in order of importance, were severity of depression in interaction with gender, motivation and the Body Mass Index (BMI). Female patients suffering from higher severity of depression, together with less motivated patients and those patients with a higher BMI all have a higher risk of dropping out during the GXT. These findings should be taken into account when using exercise tests and exercise prescription for psychiatric patients.