bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 24-hour postural care service: Views, understanding and training needs of referring multidisciplinary staff
Authors: Castle Darren , Stubbs Brendon , Clayton Sarah , Soundy Andrew 
Published: May 2014

Aims To consider the views, understanding and training needs of members of a multidisciplinary team (MDT) around 24-hour postural care. These MDT members refer individuals with profound and multiple learning disabilities (PMLD) and postural care needs to a 24-hour postural care service. Methods This study used a mixed-methods approach, which was undertaken in two phases. The setting for this study was a community healthcare NHS trust in England, which refers patients to physiotherapy for PMLD. Phase 1 involved 57 members of the MDT including: psychologists, psychiatrists, community nurses, health facilitation nurses, speech and language therapists, and occupational therapists. Phase 2 involved a purposive sample of 14 MDT members across three profession-specific focus groups. Findings Phase 1 identified that around 50% of all MDT members refer to the 24-hour postural care service; the majority (75.4%) of these participants identified that they would be happy to receive more training on 24-hour postural care. Phase 2 suggested that while referrals were being made, MDT members were not able to identify why individuals should be referred to the 24-hour postural care service. Conclusions This study has revealed that MDT members working in a community trust within learning disability services were lacking an awareness of why individuals should be referred to 24-hour postural care. This study discusses the implications of this finding.
Factors influencing patients' hope in stroke and spinal cord injury: A narrative review
Authors: Soundy Andrew , Stubbs Brendon , Freeman Paul , Coffee Pete , Roskell Carolyn 
Published: May 2014

Aims: The purpose of this research is to help health-care professionals (HCPs) consider how hope is promoted and challenged during the rehabilitation of patients who have had a stroke or spinal cord injury (SCI). Background: Stroke and SCI are two chronic neurological conditions that require significant neurological rehabilitation. During the process of neurological rehabilitation, several internal, external or environmental factors can influence a patient's hope. While research has identified the importance of hope, it has not explicitly identified which factors influence patients' hope. Neither has existing research provided an evidence-based understanding of how health professionals can use strategies to help maintain patients' feelings of hope during rehabilitation. Methods: A qualitative narrative review was undertaken. Following a systematic search, 17 qualitative articles were identified that met the inclusion criteria. Thematic analysis was used to enable information to emerge regarding the strategies that promote hope and the factors that challenge hope. Results: The results included five hope-generating factors and four factors that challenged hope. Conclusions: This article identified several factors that influenced the hope of patients who have had a stroke or SCI. Hope is influenced by personal, social and situational factors, and many of these factors can have both positive and negative effects. Therefore, HCPs need to understand how to implement these ideas effectively. The current findings consider this.
The psychological and social aspects of a physical rehabilitation programme for fire service personnel
Authors: Dawson Linda , Deary Vincent , Amy Fielden 
Published: May 2014

Aims; There is a demand for a more precise clarification of how and why complex interventions in rehabilitation settings work. This study uses clients' experiences to better understand the contextual factors of a residential rehabilitation programme, based on a biopsychosocial approach, for fire service personnel. Methods; This study used a qualitative approach and collected data from focus groups. Two focus groups using a creative technique were undertaken to derive themes for an interview guide for the two traditional focus groups that followed. The data were analysed using thematic analysis. Results; The focus groups showed that the shared fire service background was key in enabling clients to return to fire service ‘banter’, which was missing during their previous isolated rehabilitation. The focus groups also showed that sharing rehabilitation stories with others in a similar position was enabling and restorative. The dissonance between self as a capable firefighter and self with injury or illness caused the clients to have to manage an altered identity. Conclusions; The disruption of self-identity caused by illness or injury is a central feature in rehabilitees' personal experience and reducing identity dissonance appears to be a central feature of successful biopsychosocial rehabilitation. This study identified that psychosocial processes contribute to effective rehabilitation and include being with others you believe to be ‘similar’ with whom to verbalise and acknowledge personal experience and peer-to-peer support.
Parents’ need for information and support following their child’s diagnosis of epilepsy
Authors: Cummins Ann 
Published: May 2014

Research on childhood epilepsy suggests that a diagnosis of epilepsy is a challenge for both the child and parents. Children with epilepsy and their parents are faced with a multitude of medical, developmental, social and emotional issues that can place additional demands on the rearing of child with epilepsy requiring comprehensive, continuing health care. Many studies exist concerning parents of children with chronic illnesses, including diabetes (Hatton et al, 1995), asthma (Hayes and Knox, 1984), cystic fibrosis (Coyne, 1997) and parents’ need for information and support. In comparison, research which has focused on parental essential needs for both information and support to assist them in caring and coping when their child has epilepsy are notably lacking internationally. This identified gap in the nursing literature concerning parents’ needs for information and support following their child’s diagnosis of epilepsy provided stimulus for this literature review. The purpose of this paper is to highlight the findings of this literature review and to inform paediatric nurses and allied health professionals of the importance of the provision of information and support to parents when their child is diagnosed with epilepsy. In this paper, the incidence, causes of epilepsy and the treatment of epilepsy in childhood are discussed. Parental fears and concerns about their child’s epilepsy are explored. Parents’ need for information and support when their child has epilepsy provides the main focus for this paper.
NMC review of pre-registration nursing education: views of the children’s and young people’s nursing academic community
Authors: Ellis Judith , Glasper Edward Alan , Horsley Angela , McEwing Gill , Richardson Jim 
Published: May 2014

The Nursing and Midwifery Council (NMC) for the UK commenced a consultation of the future configuration of pre-registration nursing in November 2007. The Association of Chief Children’s Nurses (ACCN) of the UK, in preparation for a joint symposium with higher education institute children’s nursing academics, undertook a SWOT analysis of the suggested changes to the existing register, with particular reference to one of the NMC’s review criteria: ‘marks relating to fields of practice (nature and number of branches versus no branches at all)’. The views of these senior children’s and young people’s nurses on the future configuration of the register were expressed earlier by Richardson et al (2007) who conclude that the existing configuration of the NMC register should remain. This analysis of the NMC consultation was later extended to some of the other criteria of the review and involved members of the children’s nursing academic community across the UK. The views reported in this paper include: Generic or common components, e.g. CFP Minimum academic level (Dip HE versus Degree) Time and content versus outcome-based approaches Use of simulation as practice learning EU specific practice learning requirements for general care. The UK academic children’s nursing departments were invited to participate by the chairperson of the ACCN by email. Data were elicited from 13 departments in academic institutions in England, Scotland and Wales who submitted electronic responses to a) the transcribed SWOT analysis conducted by the membership of the ACCN and b) the other criteria of the NMC review. An analysis of the data confirms that academics favour the retention of a direct entry children’s nursing field of practice.
MyKidneyCare App: using smartphone technology to engage young adults in their kidney care
Authors: Nottage Clare , Tibbles Rosamund , Cox Sue 
Published: May 2014

Patient engagement, in self-managing a long-term kidney condition and for continued communication with healthcare providers, is well recognised as being a key influencing factor in treatment concordance and improved health outcomes. The ability to adapt care and services to maintain relevance for patient groups is a constant challenge to those caring for young adults. Identifying innovative solutions and collaborative working with both patients and multi-agencies is pivotal in bringing young adult services into line with modern technology and communication methods. The MyKidneyCare app is a handheld patient record, communication and self-management tool. Using mobile technology aims to support young adults with their transition from paediatric to adult kidney services, aid self-management of their kidney condition and signpost them to important information resources. Smartphone technology was identified by young adults as being relevant and useful as a means of managing their own kidney care needs and promoting better self-awareness and communication with their multidisciplinary healthcare team. MyKidneyCare app is a self-management tool, which complements a range of age-appropriate services and tools designed to increase the likelihood of young adult engagement with their kidney care teams and concordance with treatment regimens.
Autologous keratinocytes cultured on benzylester hyaluronic acid membranes in the treatment of chronic full-thickness ulcers
Authors: Hollander D. , Stein M. , Bernd A. , Windolf J. , Pannike A. 
Published: May 2014

Keratinocytes were obtained from three patients with chronic full-thickness ulcers of different aetiologies. The cells were isolated, cultured and then seeded on to a membrane composed of benzylester hyaluronic acid. Once the keratinocytes had become subconfluent, the keratinocyte-containing matrix sheets were then applied as autologous grafts to the patients' ulcers.Results indicate that autologous grafting of keratinocytes cultured on benzylester hyaluronic acid membranes provides improved graft handling, reduces total time required for tissue cultivation and enhances cellular vitality because of the possibility of grafting at a subconfluent non-differentiated stage.
Studies of a new multi-layer compression bandage for the treatment of venous ulceration
Authors: Scriven J.M. , Bello M. , Taylor L.E. , Wood A.J. , London N.J.M. 
Published: May 2014

This study aimed to develop an alternative graduated compression bandage for the treatment of venous leg ulcers. Alternative bandage components were identified and assessed for optimal performance as a graduated multi-layer compression bandage. Subsequently the physical characteristics and clinical efficacy of the optimal bandage combination was prospectively examined. Ten healthy limbs were used to develop the optimal combination and 20 limbs with venous ulceration to compare the physical properties of the two bandage types. Subsequently 42 consecutive ulcerated limbs were prospectively treated to examine the efficacy of the new bandage combination. The new combination produced graduated median (range) sub-bandage pressures (mmHg) as follows: ankle 59 (42–100), calf 36 (27–67) and knee 35 (16–67). Over a seven-day period this combination maintained a comparable level of compression with the Charing Cross system, and achieved an overall healing rate at one year of 88%. The described combination should be brought to the attention of healthcare professionals treating venous ulcers as a possible alternative to other forms of multi-layer graduated compression bandages pending prospective, randomised clinical trials.
Pulse oximetry: a new tool to assess patients with leg ulcers
Authors: Bianchi J. , Douglas W.S. , Dawe R.S. , Lucke T.W. , Loney M. , McEvoy M. , Urcelay M. 
Published: May 2014

A study investigating whether pulse oximetry could be a useful way of assessing whether patients with leg ulcers are suitable for treatment by graduated elastic compression. The objective of the study was to investigate pulse oximetry as a guide to assessing patients with leg ulcers before treatment. Graduated elastic compression is the treatment of choice for uncomplicated venous leg ulcers, but is contra-indicated in patients with significant arterial disease. The standard assessment of arterial insufficiency by Doppler ultrasound ankle brachial pressure index (ABPI) has shortcomings which prompted this investigation of pulse oximetry as a possible additional, or alternative, method of assessment of patients with leg ulcers, prior to treatment with compression. The study, carried out on a population of patients attending hospital leg ulcer clinics, was designed to evaluate pulse oximetry assessment in the selection and monitoring of patients with venous leg ulceration leading to a prospective controlled study of ulcer healing in groups of patients with reduced and normal ABPI, selected for compression therapy by pulse oximetry criteria. Outcome measurement required followup of patients selected for compression therapy by pulse oximetry to record time to healing and rate of healing of leg ulcers. Results from the study show a fair correlation between the toe-finger oximetry index (TFOI) and Doppler ABPI. There is no difference between ulcer healing in patients with reduced and normal ABPI selected for treatment on the basis of pulse oximetry maximum compression pressure (MCP). In conclusion, pulse oximetry is an aid to the selection of patients who will benefit from compression therapy, but would be excluded on the basis of Doppler ABPI.
A comparison of three primary non-adherent dressings applied to hand surgery wounds
Authors: Terrill P.J. , Varughese George 
Published: May 2014

This study reports the results of a prospective randomised controlled trial that compared three non-adherent wound dressings applied to hand surgery wounds. Paraffin-impregnated gauze (Jelonet) was compared with a cellulose, acetate fibre dressing coated with a petrolatum emulsion (Adaptic) and a polyamide net dressing impregnated with silicone gel (Mepitel). The dressings were assessed for their ease of application and removal, pain on removal and wound appearance. Results from 99 patients were available for analysis. Adaptic was significantly easier to remove (p<0.01), required less soaking (p<0.05), was less painful to remove (p<0.05) and caused less wound maceration (p<0.05) than Jelonet, but was significantly more difficult to apply (p<0.05). Mepitel was also easier to remove but this did not reach statistical significance. It was also more difficult to apply than Jelonet (p<0.05). We recommend that Adaptic should be used routinely as the non-adherent dressing for incisions or traumatic wounds on the hand. The slight increased difficulty in applying the dressing is outweighed by the major advantages associated with its removal.
Is tap water a safe alternative to normal saline for wound irrigation in the community setting?
Authors: Griffiths R.D. , Fernandez R.S. , Ussia C.A. 
Published: May 2014

Objective: This double-blind randomised controlled trial compared the effects of tap water and normal saline on the healing and infection rates of acute and chronic wounds. Method: The trial was conducted in two metropolitan community health centres in New South Wales, Australia. Thirty-five patients with 49 acute or chronic wounds were randomised to receive wound irrigation with either normal saline or tap water. Results: Statistical analysis demonstrated there was no significant difference between the infection and healing rates in wounds irrigated with normal saline or tap water. Conclusion: Although the small sample size is a limitation of this study, the researchers conclude that drinkable tap water appears to provide a safe alternative to normal saline for wound cleansing and may be preferred by some patients. Declaration of interest: None
An in-vitro study of the pressure-relieving properties of four wound dressings for foot ulcers
Authors: Ashford R.L. , Freear N.D. , Shippen J.M. 
Published: May 2014

This in-vitro study reports on a selection of mechanical tests on four wound dressings: Allevyn (Smith and Nephew), Biatain (Coloplast), Lyofoam (Seton Scholl) and Tielle (Johnson and Johnson). The aim of the study was to investigate these dressings in the laboratory by subjecting them to dry and wet compression tests, shearing tests and a cyclical test. As predicted, all dressings performed differently in the range of tests, with Lyofoam deforming the most when subjected to compression testing (5.6mm). During wet compression, differences in the physical properties of all the materials tested were identified. During shearing testing, Allevyn and Tielle withstood the greatest shear deflection before failure, but Biatain withstood the greatest force before failing. During the cyclical testing, Lyofoam only reduced by 1% of its original thickness, while Biatain reduced by 30%. No one dressing performed better in all the tests. However, as an all-round ‘pressure-relieving’ dressing, Allevyn consistently outperformed the others in the study.
Measuring the incidence of lower limb ulceration in the Chinese population in Hong Kong
Authors: Wong I. 
Published: May 2014

Objective: This retrospective study set out to examine the incidence, patient characteristics and current practice among patients with ulcers on the lower leg and foot who were under the care of the community nursing service of a regional hospital in Hong Kong. There is no clear differentiation between leg ulcers and foot ulcers in local practice in Hong Kong. Method: The nursing records of 819 subjects receiving treatment at home from the regional hospital's community nursing service were reviewed. All were active cases on 31 October 2000. Results: The patients' median age was 76 (range: 36–100); 86% were aged over 65. Seventy-five percent of the patients had dressings changed daily, with 28 types of dressing being used. Nurses changed dressings in the patients' homes or in residential homes. Of the 94 patients with ulcers on the lower leg and foot, 75% had their dressings changed daily and only six less than three times a week. Fifty-four percent received regular podiatry clinic follow-up. Conclusion: Care of patients with ulcers on the lower limb represents a considerable workload for community nurses in Hong Kong, where little attention has been paid to the problem and current treatments. The number of patients with these ulcers cared for by community nurses in Hong Kong was high, with wide variations in management. Further investigation into evidence-based practice is needed to develop clinical guidelines and protocols that will achieve quality care. Research is now required in a clinical setting and for comparison with existing wound-care products. Declaration of interest: None.
Can a decision tree help nurses to grade and treat pressure ulcers?
Authors: Verdu J. 
Published: May 2014

Objective: This study investigated whether a decision tree can aid pressure ulcer management. It hypothesised that nurses who use a decision tree in pressure ulcer care assess wound grade more accurately and select more appropriate dressings. Method: Sixty-six nurses were randomly assigned to two groups. Each nurse reviewed written information and pictures of three cases of pressure ulceration, and then graded and selected a dressing for the lesions. The absence or presence of a decision tree was used as an independent variable. Measurements included: mean and standard deviation; confidence intervals; percentages; Chi-square test, Pearson's correlation and Kruskal-Wallis test. Results: Baseline characteristics were comparable for both groups. There was no statistically significant difference between the grades selected by the two groups. But significantly more of the decision tree users selected an appropriate dressing (p<0.02). Joint scores (ranging from 0 to 6) were assigned for each accurate decision. The mean score for the experimental group was 4.47 ±1.14 (95% CI: 0.95 [4.06–4.88]) and for the control group, 3.35 ±1.30 (95% CI: 0.95 [2.90–3.81]). Conclusion: Decision trees could help nurses to make complex clinical decisions. Further studies undertaken in a clinical setting are needed. Declaration of interest: None.
The hidden side of nursing: why caring for patients with malignant malodorous wounds is so difficult
Authors: Wilkes L.M. , Boxer E. , White K. 
Published: May 2014

Objective: This cross-sectional qualitative study used semi-structured telephone interviews with palliative care nurses working in urban and rural settings in Australia to explore their experiences of dealing with patients with malignant, often malodorous, wounds. Method: This paper was the second phase of a research project examining the care of patients with malignant wounds. Of 71 palliative care nurses in New South Wales invited to participate, 26 took part, 17 of them working in community positions. The data from the telephone interviews were transcribed and analysed, using content analysis, and coded for themes relating to the nurses' experiences of caring for this patient group. Results: Nurses working in this setting strove to do the best for patients and their families under circumstances that are emotionally and physically difficult. Some of them suffered personal distress as a consequence. Patient isolation and altered body image are significant challenges for these nurses. Conclusion: The nature of the work these nurses do, in particular the fact that they are dealing with cancers, tends to push them into literal and practical silence. But the researchers question whether this is always the best option. They ask if hiding feelings could be bad for nurses and patients alike. In qualitative research it is not appropriate to generalise the results, although lessons can be learnt from the experience of this group. Declaration of interest: This research was funded by a grant from the University of Western Sydney.
Effect of intermittent radiant warming on proliferation of human dermal endothelial cells in vitro
Authors: Hughes M.A. , Tang C. , Cherry G.W. 
Published: May 2014

Objective: This study investigated the effect of Warm-Up therapy on the proliferation of human microvascular dermal endothelial cells. Method: Endothelial cells from an adult subject were seeded in six-well plates and placed in an incubator at 32.5°C. The following day Warm-Up dressings were placed over the plates, with or without warming cards. Cards set at 38°C or 42°C raised the temperature in the medium to maxima of 34.5°C and 37.5°C respectively. Units were switched on daily for three one-hour periods. Cell numbers were counted by haemocytometer. Results: Maximum stimulation of endothelial cell proliferation occurred under the 38°C card, with cells numbering 135–158% of the controls (p<0.05). The 42°C card also stimulated cells (110–155%) but this did not reach statistical significance. Conclusion: The accelerated proliferation of microvascular dermal endothelial cells achieved by intermittent radiant warming may have contributed to the increase in granulation tissue reported previously in our clinic. Declaration of interest: This study was sponsored by an educational grant from Augustine Medical.