bluuebunny/crossref_metadata_2025_split huggingface dataset:
Balloon gastrostomy tubes for long-term feeding in the community
Authors: Ojo Omorogieva 
Published: May 2014

Aim: Dysphagic patients with functional guts often receive nutritional and hydration support through enteral feeding tubes. These include percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) tubes. The balloon gastrostomy tube (BGT) as a primary tube of choice in tube-fed patients, including head and neck cancer patients, offers a new approach to enteral tube feeding in the community. There are complications associated with the use of enteral feeding tubes. This study compared the complication rates and the costs of PEG tubes and BGTs in patients on long-term enteral feeding in the community and looked at the possible use of BGTs as an alternative to PEG tubes. Methods: The records of all 15 BGT-fed patients on the caseload and 15 randomly selected PEG tube-fed patients were reviewed. The study was based on two consecutive visits to these patients. Tube and stoma complications were clinically scored in order of increasing severity (0–10) and statistically tested. The prevalence of stoma and tube complications was expressed in percentages. Results: There was no significant difference (P>0.05) in the overall clinical scores between BGT-fed and PEG tube-fed patients at both initial and final visits. However, with regard to specific complications—infected sites, tube dislodgement, overgranulation, and infection with overgranulation—significant differences were observed between the two groups of patients at the initial and final visits. In addition, the total costs of inserting and managing BGTs were significantly higher than those for PEG tubes. Conclusions: Although BGTs may be used as analternative to PEG tubes in patients on long-term enteral feeding in the community, the higher cost of using BGTs over PEG tubes should be considered when selecting feeding tubes for these patients.
Attitudes to sexuality of patients with learning disabilities: a review
Authors: Futcher Sarah 
Published: May 2014

Objective: A critical review of the literature to determine the attitudes of staff and families towards the sexuality of adults who have learning disabilities. Design: An evidence-based practice literature search of all published studies conducted since 2000. This included a comprehensive review of books, electronic databases, grey literature and hand-searching. Four key studies were identified and subjected to critical analysis. Method of critique: The four key studies yielded were critically analysed using a framework developed by Parahoo (2006) . This critiquing tool identifies seven key areas: title, abstract, literature review, methodology, data analysis and results, discussion and interpretation, and conclusions and recommendations. Results: All four studies uniquely addressed similar issues in practice; there are areas of bias and concerns about the reliability of some of the studies critiqued. Similar themes were identified, suggesting that the results could be replicated in further studies. Education for staff was a key theme throughout the studies. Conclusions: Education for staff is vital to ensure that a consistent approach is taken to support adults who have learning disabilities to express their sexuality. In order to facilitate the changes required in practice, leadership, education and a support network are required. Recommendations from this review include training on leadership and on the sexuality of adults with learning disabilities for all staff.
The role of the ward manager in promoting patient safety
Authors: Pinnock David 
Published: May 2014

In this article the role of the ward manager in promoting patient safety is explored. The background to the development of the patient safety agenda is briefly discussed and the relationship between quality and safety is illustrated. The pivotal importance of the role of the ward manager in delivering services to patients is underlined and literature on patient safety is examined to identify what a ward manager can do to make care safer. Possible actions of the ward manager to improve safety discussed in the literature are structured around the Leadership Framework. This framework identifies seven domains for the leadership of service delivery. Ward managers use their personal qualities, and network and work within teams, while managing performance and facilitating innovation, change and measurement for improvement. The challenge of promoting patient safety for ward managers is briefly explored and recommendations for further research are made.
Managing the acutely ill adult with sickle cell disease
Authors: Brown Marvelle 
Published: May 2014

Sickle cell disease (SCD) is an autosomal recessively inherited condition, affecting the structure of the haemoglobin. SCD is a long-term chronic condition which is manifested by periods of acute painful sickling crisis, known as vaso-occlusive crisis (VOC) and is the cause of 90% of sickle cell-related hospital admissions. SCD is one of the most common genetic conditions worldwide and in the UK there are approximately 12 500 people living with it ( Streetly et al, 1997 ; Howard et al, 2008 ), making it more common than cystic fibrosis, yet there still remains many challenges in managing these patients when they become acutely ill. Lack of awareness and understanding of the illness, concerns regarding addiction and limited attention to the psycho-social implications of the illness, leads to less than effective care for this patient group when they are hospitalized. The aims of this article are to outline the pathophysiology of SCD, identify the causes ofVOC and discuss the key principles of nursing management for patients experiencing a VOC.
Students' experiences of electronic health records in practice
Authors: Baillie Lesley , Chadwick Sandra , Mann Robert , Brooke-Read Melanie 
Published: May 2014

Aim: The purpose of the study was to investigate nursing and midwifery students' experiences of electronic health records (EHRs) in practice. Background: As EHRs are increasingly being implemented in the NHS, student nurses and midwives are gaining experience in their use. Method: Three focus groups were conducted on a university campus in England: one with midwifery students (n=6); one with mental health nursing students (n=5); and one with adult nursing students (n=6). The focus group data was analysed thematically after transcription. Results: Students perceived the benefits of EHRs for care delivery as better information availability and quality of record keeping. Their concerns related to practical and logistical issues, and difficulties in adjusting to electronic systems. Conclusion: If students have positive experiences with EHRs during training and have opportunities to use EHR systems while on placement, they are more likely support the implementation of EHRs as they enter the workplace as qualified staff.
Health and medical services for the 2012 Olympic Games
Authors: Venning Pam 
Published: May 2014

This summer, London will become the first city to host the Olympic Games for a third time. The last time the torch made its way around the UK was 1948; a year many will associate with the inception of the NHS. On 5 July, the NHS took control of 480 000 hospital beds in England and Wales, and an estimated 125 000 nurses were on hand to care for patients ( Tweddell, 2008 ). Only a few weeks later, the London Olympics opened at Wembley Stadium, and as there was no Olympic Village, many athletes were housed in nursing accommodations ( Lane, 2010 ) Both the Olympic Games and the birth of a public health service made a significant mark on the UK landscape, and in the 64 years that followed, many things have changed. Some things, however, remain the same; nurses continue to serve the public with commitment, spirit and pride. Not only will hundreds of nurses feature in the 2012 Olympic Games opening ceremony ( Ford, 2012 ), they will also play an important role in delivering the medical services planned for the event.
Staff perceptions of respiratory rate measurement in a general hospital
Authors: Philip Keir , Richardson Ruth , Cohen Maurice 
Published: May 2014

Background: the National Institute for Health and Care Excellence (NICE) (2007) states that ‘respiratory rate is the best marker of a sick patient and is the first observation that will indicate a problem or deterioration in condition’. It is therefore crucial that staff are confident that respiratory rates are recorded accurately. Aims: to assess perceptions of clinical staff regarding methods of assessment and reliability of respiratory rate recordings in observation charts. Methods: we developed a questionnaire using best practice guidelines. Some 41 ward-based clinical staff completed the questionnaires. Findings: confidence in the reliability of recordings is very low. Clinical staff think recordings are often estimated with no formal measurement, with ‘perceived lack of time’ being the most commonly cited explanation for inappropriate assessment. Conclusions: essential clinical information is not being used, as clinical staff lack confidence that it has been assessed correctly. Furthermore, inaccurate recordings could be actively misleading clinical care.
Gastro-oesophageal reflux. Part 1: smoking and alcohol reduction
Authors: Talalwah Narmeen Al , Woodward Sue 
Published: May 2014

Introduction: Gastro-oesophageal reflux disease (GORD) is defined as an abnormal reflux of the stomach contents into the oesophagus, which provokes symptoms and impairs the quality of life. GORD has a high prevalence and incurs costs to the healthcare system. This is the first paper in a series of three exploring the conservative, medical and surgical treatment of GORD. This first paper presents a review of the effect of smoking and alcohol on reflux symptoms and the impact of smoking and alcohol reduction on symptoms of GORD. Methods: A search for English language studies on adults was conducted using three databases, MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL). Eleven relevant studies were included in the review. Findings: The effect of alcohol on the stimulation of reflux has been debated over the years in different studies. Some studies state that alcohol consumption induces reflux and moderate amounts exacerbate nocturnal gastrooesophageal heartburn reflux. However, other studies have found no association between alcohol consumption and reflux. Most reflux occurs during smoking because nicotine causes the lower oesophageal sphincter to relax, which increases the risk of reflux. Similarly, the number of cigarettes smoked is associated with the risk of reflux. Conclusions: Nurses need to be aware of the effect of smoking and alcohol on reflux to provide evidence-based advice to empower patients to change their lifestyle, which results in increased therapeutic compliance and a better clinical status. There is no evidence that reducing alcohol consumption decreases symptoms and only limited evidence on the effectiveness of smoking cessation. Further research into the effectiveness of these lifestyle modifications is therefore required.
Pressure ulcers in Jordan: a snapshot survey of a tertiary public hospital
Authors: Alja'afreh Mahmoud , Mosleh Sultan M 
Published: May 2014

Background:Patients are at risk of developing pressure ulcers while they are hospitalised. These risks need to be managed effectively to avoid harm and to minimise costs.Objective:This study was aimed at determining the prevalence and incidence of pressure ulcers at selected acute clinical settings in central Jordan.Design:A cross-sectional survey design.Method:An inpatient snapshot survey was conducted over 4 weeks in the two medical wards in a tertiary public hospital.Results:190 participants were surveyed, 30 cases were identified, 53% were male, and 75% were aged 60 years or older. Prevalence was 24%, approximately half of the cases were grade 2 and 23% were grade 3 and 4. Pressure ulcers were mainly found on the sacrum (43%), followed by the heel (24%). Over 4 weeks, 29 new pressure ulcer cases were identified; 55% were male, and 90% were aged 60 years or older. Pressure ulcers were mainly—in 38% of cases—identified with cerebral vascular accident patients.Conclusion:The results of the snapshot survey confirmed that there is a problem with maintaining patients' safety in terms of patients acquiring pressure ulcers in hospital. The number of pressure ulcers indicate less-than-optimal management of patient safety, which requires a more detailed investigation.
Improving care of patients with metastatic spinal cord compression
Authors: Warnock Clare , Hodson Suzanne , Tod Angela , Mills Rebecca , Crowther Lesley , Buchanan Jean , Foran Bernadette 
Published: May 2014

Metastatic spinal cord compression is a feature of advanced cancer and the incidence is likely to increase alongside improved survival rates. Patients with spinal cord compression have complex physical, psychological and social care needs. This article describes a multidisciplinary project aimed at improving the care provided to newly diagnosed patients who were admitted to a regional cancer centre for radiotherapy. The project used a range of approaches to measure care, develop and implement interventions, and evaluate outcomes. Aspects of care reviewed in the project included mobilisation, medications including steroids and thrombo-prophylaxis, bowel management, patient priorities and concerns, discharge planning and early detection.
Continuing Professional Development: Managing travel phobia and anxiety
Authors: Koch Hugh , Knight Alice , Payne Louise , Thorns Tracy 
Published: May 2014

Overview This article describes in detail what constitutes a travel phobia and the effects of traffic accidents on driver and passenger behaviour and confidence. It examines the specific causes and factors. The mental health practitioner's role in recognising, evaluating treating and/or giving health education advice is explored. Self-assessment questions are given to test the reader's knowledge.
Complexities of supporting teenagers in pregnancy
Authors: Thompson Sue 
Published: May 2014

This article describes the multifactorial issues that are involved when providing appropriate care to teenagers who become pregnant. The teenage pregnancy clinic was set up over 10 years ago in Liverpool by an innovative midwife, Lorna Wood, with the support of a consultant obstetrician. The pregnant teenager’s journey begins at the booking in visit, continuing throughout antenatal care and ends at the postnatal visit, approximately 6 weeks after the birth. The article highlights the importance of the careful, accurate assessment of each individual in order to provide an optimum, flexible plan of care for both mother and baby. The success of the clinic can be measured in many ways, not least the very low rate of non-attendance. The outcomes are good and the rate of repeat pregnancies is low (less than 3% each year). This is in part owing to the provision of contraception at the postnatal visit and continuity of care throughout by the two midwives involved.
Contents of Swedish school health questionnaires
Authors: Ståhl Ylva , Enskär Karin , Almborg Ann-Helene , Granlund Mats 
Published: May 2014

Aim: This study aims to analyse and link the content of the health information requested in questionnaires used locally in Swedish child and school health services. Background: In industrialized countries, children’s health needs are changing from physical to psychosocial needs and the questionnaires used for health screening and guiding health promotion must therefore adapt to these changes. Methods: Questionnaires were analysed, together with health items linked to the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). The inter-rater agreement for linking was 80%. Standard age groups were used to improve the comparability across different questionnaires. Results: The information requested for the youngest children focused on communication and acquiring language. For the children aged 6 years and above, health questionnaires related to mental functions, the school situation, psychosomatic symptoms and issues associated with taking care of one’s health. Conclusions: The information relating to health in questionnaires revealed that interest focused on health items strongly related to the different age groups and to psychosocial health. The focus was the child as a person rather than the child within a family and school environment.
Looking at skin cancer and effective sun protection
Authors: Knight Claire 
Published: May 2014

Rates of malignant melanoma, the most serious type of skin cancer, have trebled in under-35s since the late 1970s in Britain. Sunburn signals damage to the DNA inside skin cells, and over time this damage can develop into skin cancer. It is therefore important that children and young people are aware of the risks of sunburn and that an effective whole-school sun protection policy is in place. This article looks at skin cancer, risk factors and effective sun protection.
Promoting a relationship-based health practice: A challenge for school nurses
Authors: Holmström Malin Rising , Asplund Kenneth , Kristiansen Lisbeth 
Published: May 2014

Background: School nurses have a unique opportunity to promote health when they meet school children during the Health Dialogue. The Health Dialogue concept is used by all the school nurses in a county in Mid Sweden. Aim: To describe school nurses’ experiences of the Health Dialogue concept. Methods: A qualitative descriptive study with latent content analysis of interviews performed during February-April 2012, where 16 school nurses participated. Findings: The school nurses experienced the Health Dialogue concept as a useful tool to work with school children's health in a relationship-based, child focused, structured, and systematic way, which was refected in one overarching theme: To be in a relationship-based, health-promoting practice.’ However, school nurses also experienced loneliness and frustration from the many difficult situations with school children, and they indicated needs for further collaboration. Conclusions: The Health Dialogue concept is child-focused, systematic and structured, but it requires further development and continuing work on statistical feedback. School nurses indicated a need for collaboration with teachers, parents, and other health professionals, as well as professional-refective supervision.
Adolescents with endometriosis: Their experience of the school health care system in Sweden
Authors: Bodén Emma , Wendel Carina , Adolfsson Annsofie 
Published: May 2014

The aim of this study was to investigate what type and level of support women diagnosed with endometriosis received in Sweden from the school medical network and school nurses during their secondary and upper secondary school years and how it affected their quality of life. A quantitative method with an inductive approach was used to collect data for the study. Young women were found to be absent from school or missing extra-curricular activities due to pain and abnormal bleeding associated with their menstrual cycles. Some of the women thought that these symptoms were normal and did not consult the school nurse as a result of their limited experience. Others did not consult with the nurses because of a perception of poor treatment. Endometriosis can be managed and adequate treatment can have a substantial impact on improving quality of life. It is important that school nurses are aware of the condition and that young women understand what constitutes a normal menstrual cycle and when they should seek help from health professionals.
Expertise in diagnostic reasoning: a comparative study
Authors: King Carol Ann , Bithell Christine 
Published: May 2014

This study compares the diagnostic reasoning of a group of 5 physiotherapists who have undertaken a formal specialist training programme and gained a qualification in musculoskeletal physiotherapy and a group of 5 equally experienced musculoskeletal physiotherapists who have not undertaken specialist training. Subjects were audiotaped as they worked through a dynamic case history and reached a clinical diagnosis. There were differences in their use of pattern recognition and self-monitoring reasoning skills. The study concludes that for this small group of physiotherapists, formal postgraduate specialist education appeared to have fundamentally changed their approach to a diagnostic task.
Recreation in stroke rehabilitation part two: exploring patients' views
Authors: Cowdell Fiona , Garrett Dawne 
Published: May 2014

Part one of this article highlighted a lack of research that investigated patients' perceptions of the need for recreational activity while undergoing rehabilitation following stroke. This article investigates whether patients perceive a need for recreation while undergoing stroke rehabilitation in an acute hospital setting. Data were collected using individual interviews and analysed using constant comparison. Participants explained how they had come to be in their current condition and described the ‘purgatory’ of having a stroke. They talked about the ‘lifelines’ that may help them recover sufficiently, one of which was recreation. Many of the findings from this study were congruent with those from other studies. However, this article highlighted a desperation that participants felt to undertake more activity and a desire to incorporate recreation into the rehabilitative milieu.
Provision of powered mobility equipment to young children: the Whizz-Kidz experience
Authors: Home Anne Marie , Ham Ros 
Published: May 2014

Locomotion and other motor skills develop rapidly during the first 3 years of life and become the primary vehicle for learning and socializing. Children with physical disabilities are denied such developmental opportunities unless they are provided with powered mobility. A retrospective survey of the experiences of children issued with powered mobility by the charity Whizz-Kidz is reported in this article.
Clinical education: a critical analysis using soft systems methodology
Authors: Rushton Alison , Lindsay Geoff 
Published: May 2014

Clinical education is an integral component of health-care professional education, providing an essential bridge between the academic and clinical environments. A soft systems methodology provided a conceptual framework for structuring an analysis of clinical education. The literature search encompassed all major databases and manual searching of key journals for health-care professions. Content analysis identified key themes, which included the balance between theoretical and clinical components of a course, timing of placements, assessment, models of placement, the supervisory process and the role of the clinical educator, student and the university tutor. The analysis identified a paucity of good quality research, with both theory–practice and literature–practice gaps in existence. The literature also highlighted the necessity for change, and the need to develop theory and research. The findings reflect that a structured approach to address the issues raised by clinical education at individual profession and interdisciplinary levels is perhaps required.