bluuebunny/crossref_metadata_2025_split huggingface dataset:
A scheme to support the recruitment and retention of allied health professionals to hard to fill posts in rural areas
Authors: Solowiej Kazia , Upton Penney , Upton Dominic 
Published: May 2014

Background This article follows on from the previous issue, where the Allied Health Professions (AHP) Support and Development Scheme was introduced. The scheme was put in place in order to aid in the recruitment, retention and career development of Allied Health Professionals (AHPs) in hard to fill posts in NHSScotland. Contents The last issue looked at how the scheme developed newly qualified practitioners' skills. This article looks at the scheme's impact on recruitment and retention. Financial incentives were provided for both the teams with hard to fill posts and the individuals who were recruited to support the recruitment, retention and career development of AHPs. The evaluation of the scheme aimed to assess the impact on recruitment, retention, career development and successful outcomes for individuals and teams of AHPs in NHSScotland. The scheme was found to have had a positive impact on recruitment and retention of AHPs to hard to fill posts. Conclusions Overall, 75% of managers had successfully recruited new team members as a result of the scheme. However the majority of new recruits (68%) reported that the financial incentive had not influenced their decision to accept the posts. Many of these recruits had remained in post and their appointment was reported to have had a positive impact on service provision. Overall the majority of AHPs (89%) would recommend the scheme to other teams with hard to fill posts
Experiences of the voluntary physiotherapist role in developing nations
Authors: Humphreys Katy , Carpenter Christine 
Published: May 2014

Aim Voluntary work is considered to be of benefit both to the community receiving services and to the practitioner providing them. However, much of the current understanding of the physiotherapy volunteer experience is anecdotal. The aim of this qualitative study was to explore the experience of volunteering as a physiotherapist in a developing country in terms of the impact on the volunteer, the nature of the role, and the benefits to the patients as perceived by the participants. Methods In-depth telephone interviews were conducted with a purposive sample of five physiotherapists. The interviews were taped and transcribed manually and verbatim. A framework was used to guide the thematic analytic process. Findings There were four main themes: barriers to practice, adapting to culture, impact on self, and impact on community. These characterize the rewards and challenges of volunteering in developing countries from a physiotherapist perspective. Conclusions The study findings suggest that voluntary physiotherapy in developing nations is most effective and meaningful when there is a genuine interest in the culture, and there is a balance of skill exchange between the foreign and native physiotherapist. Implications for practice and further research are discussed.
Training speech-language pathology graduate clinicians to administer the National Institutes of Health Stroke Scale
Authors: I Zraick Richard , C O'Neill Ashley , C Robinson Gregory , K McWeeny Elizabeth , J Hutton Terri 
Published: May 2014

Aims The National Institutes of Health Stroke Scale (NIHSS) is an 11-item assessment measuring the severity of an individual's stroke. Though neurologists, emergency room physicians, nurses, occupational therapists and physical therapists have completed the certification process for NIHSS administration, no study to date has examined whether speech-language pathologists (SLPs), or those in training, can be certified to administer the NIHSS. The aim of this study was to examine whether SLP graduate student-clinicians could be certified to administer the NIHSS. Methods Twenty student clinicians achieved Group A certification from the NIHSS training DVD, then were subsequently tested on NIHSS scoring for six patient vignettes from Group B of the training DVD. Findings No student achieved certification for the Group B patients. Conclusions The results of this study suggest that basic NIHSS training is not sufficient to ensure certification. In addition, the minimum requirements for NIHSS certification may not be adequate for any individual to reliably and accurately administer the scale. Measures to facilitate certification are discussed, including the need for extensive clinical exposure to stroke patients.
Overcoming the long-term effects of stroke: qualitative perceptions of involvement in a group rehabilitation programme
Authors: Schouten Linda , Murray Carolyn , Boshoff Kobie 
Published: May 2014

Linda Schouten, Carolyn Murray, Kobie Boshoff Aims: This article describes a study evaluating a stroke rehabilitation group programme from multiple perspectives, at a community based day therapy centre in South Australia. The group programme involved goal directed exercise and functional/cognitive activities for one hour a week, over eight weeks. Methods: The study used an interpretive qualitative approach aimed to explore group member and facilitator perceptions about their involvement in the programme. In depth interviews were used for four group members with stroke, and three staff clinicians involved in the programme facilitation. The interview questions used for both types of participants were the same. In-depth thematic analysis was undertaken to interpret and combine the data from the interviews. Findings: Six themes emerged: ‘a place to go’, ‘diversity of the group’, ‘the art of group design’, ‘awareness of abilities through doing’, ‘it's about relationships’, and ‘over and above’. Conclusions: These findings support the use of a group approach to rehabilitation aiming to address the long-term effects of stroke. Psychosocial benefits emerged which were beyond the expected functional aims of the programme. Some recommendations are made about group structure and design based on the evaluation.
Influences on women's completion of a cardiac rehabilitation programme
Authors: Sherwood Sarah A , Povey Rachel C 
Published: May 2014

Sarah A Sherwood (née Pullen), Rachel C Povey Aims: This article describes a study investigating patient and programme factors influencing women's completion of a cardiac rehabilitation (CR) programme. Methods: A qualitative cross-sectional design was adopted. Semi-structured interviews were conducted with five women who had completed and five women who did not complete the CR programme. An interpretative phenomenological analysis was conducted on the reviews; both individually and within the two groups (‘completers’ and ‘non-completers’). This entire process was also undertaken by a second researcher, and led to the emergence of a list of both individual themes and master themes for each group. Findings: Positive influences on completion included a correct medical understanding, successful behavioural changes in terms of lifestyle control, approach-focused coping, addressing support needs and positive recognition for the role of CR. Negative influences on completion included incorrect medical understanding, limited lifestyle changes, emotion focused coping, high degree of concern on the impact of significant others and lack of perceived consistent value of CR. Conclusions: In order to improve completion rates for CR programmes among women with heart disease, it is important to clarify their initial medical understanding and beliefs, and to continually reassess their perceptions during programme delivery. Incorporating individual support, flexibility, and bespoke programmes for different age groups may enhance attendance at cardiac rehabilitation programmes.
The role of spirituality through adaptive sport in the identity adaptation of wounded Service personnel
Authors: Green Sarah 
Published: May 2014

Background: Traumatic, life-changing injuries often require a re-adjustment of identity, but we have yet to explore the impact that adaptive sport may have on the identity adaptation and the meaning of life for wounded Service personnel post traumatic injury. Content: By presenting an analysis of adaptive sport as a tool for dealing with post-traumatic injury, this article will focus on some of the reasons why participation in adaptive sport may benefit identity adaptation and have spiritual, existential meaning. Conclusion: It is clear that more work needs to be done to assess the impact of traumatic injuries and how they affect the identity and the meaning of life for wounded Service personnel. The spiritual, existential experience of adaptive-sport-rehabilitation can be recognised as a therapy to bring back meaning to the lives of the wounded and help them adjust to their newly defined identity by providing purpose and achievement.
Evaluation of clinical guidelines for contracted (frozen) shoulder 12–18 months after publication
Authors: Hanchard Nigel , Goodchild Lorna , Thompson Jackie , O'Brien Tracey , Richardson Chris , Watson Helen 
Published: May 2014

Background/aim: To obtain an early indication of the dissemination of evidence-based physiotherapy guidelines for contracted (frozen) shoulder and to explore how the guidelines’ recommendations correspond with practice. Methods: The authors monitored downloads of the guidelines for the 18 months after publication. This study also used a self-administered, anonymous online questionnaire survey, which targeted UK-based physiotherapists who had accessed the guidelines by 12–18 months after publication. The survey's questions required ‘yes’ or ‘no’ responses and ‘yes’ responses activated questions asking whether practice had changed. With ethics clearance, and following piloting, the survey was advertised electronically. Analysis was by frequency counts. Results: There were 6 185 de-replicated UK downloads of the guidelines, most via the Chartered Society of Physiotherapy website. There were 366 survey responses. The median correspondence between the guidelines’ recommendations and practice was 66%, mostly reflecting validation of practice, but some change of practice. Notably among the diagnosis and assessment recommendations, passive external rotation was widely used as a pathognomonic test (75%). The proposed pain-predominant/stiffness-predominant classification was widely adopted (66%), and 88% of those who asked their patients said those patients found this terminology meaningful. Only 34% of responders reported using validated outcome measures. Correspondence of practice with the guidelines’ treatment recommendations was high for out-patient physiotherapy and injection but low for shortwave diathermy. Conclusion: The wide distribution and survey results suggest that the guidelines’ development was worthwhile. There were some areas of poor implementation of the guidelines’ recommendations, explicable by known obstacles; however, the findings provide a timely indication of where supplementary efforts should be targeted, e.g. using validated outcome measures.
Physical activity and sedentary behaviour in outpatients with schizophrenia: A systematic review and meta-analysis
Authors: Soundy Andrew , Wampers Martien , Probst Michel , De Hert Marc , Stubbs Brendon , Vancampfort Davy , Attux Cecelia , Leutwyler Heather , Ströhle Andreas 
Published: May 2014

Aims: To identify, appraise and synthesise evidence on the level of physical inactivity or activity and its moderators in outpatients with schizophrenia. Method: A systematic search strategy was undertaken and included eight electronic databases. Searches were undertaken using a subject and text-word search strategy between the dates from each databases' inception to September 2012. Two independent reviewers determined study eligibility. Data extraction detailed the level and time spent in physical activity. Results: One hundred and sixty three records were screened, and 12 studies (n=628) met the inclusion criteria. A meta-analysis identified higher levels of sedentary activity (N=2; n=140; z=44.1; P<0.001) and low categories of physical activity (N=2; n=140; z=147,306; P<0.001), and lower levels of moderate (N=3; n=300; z=-5.1; P<0.001) and vigorous (n=3; n=220; z=-3.2; P=0.001) physical activity categories when comparing patients with schizophrenia to healthy age- and gender-matched controls. Meta-regression found no significant association between moderate and vigorous physical activity with age (P=0.08; P=0.14 respectively) and gender (P=0.08; P=0.14 respectively) as the moderators. Conclusion: The current study is the first to provide meta-analytic evidence for the sedentary behaviour and lack of physical activity in outpatients with schizophrenia.
Workforce innovation through mentoring: An action research approach to programme evaluation
Authors: Akhurst Jacqueline , Lawson Sally 
Published: May 2014

Background: The North East Neurosciences Network Workforce Innovations Programme used mentoring to develop neuro-practitioners’ specialist skills and efficacy in health and social care settings. The programme aimed to improve services and outcomes for and with people living with long-term neurological conditions by enhancing practice and partnership building. This study used action research to evaluate the programme’s impact over an 18 month period, in collaboration with a group of 10 mentors, their mentees, and the programme’s steering group. Content: This study describes the action research undertaken for evaluating this 18-month mentoring programme, showing how the research questions, data collection and analysis evolved. It demonstrates how the approach facilitated participants’ reflections, enabling them to evaluate and improve their practice. The evaluation shows how the programme equipped participants with skills for partnership and community-based approaches. The participants’ experiences of using action research in this way are explored; and the challenges that arose in the context of a rapidly-changing health service are described. Conclusions: Noteworthy features of the programme include its evolving collaborative nature, the integration of action research from the start, and the coherence of action research with other elements of the delivery. Changes in participants’ approaches illustrate the potential contributions of this type of programme within a community of practice, to develop personal efficacy in a context broader than a ‘specialism’ and as an alternative to traditional in-service training. Improved ways of working impacted on inter-collegial practice, service delivery and outcomes, translating policy into action.
Screening for Down's syndrome
Authors: Kochha Suneeta 
Published: May 2014

“Down's syndrome results from a chromosomal abnormality (trisomy of chromosome 21). It may also result from mosaicism and chromosomal translocations. The combined test (nuchal translucency test, beta-HCG and PAPP-A) is the preferred screening method in the first trimester of pregnancy. Screening with the integral test leads to a detection rate of 85 per cent.”
Rural acute myocardial infarction survey (RAMIS)
Authors: Nudell Nikiah , Rice Don , Gale John A. , Wingrove Gary , Bouthillet Tom 
Published: May 2014

Objectives: The purpose of this study was to evaluate why current treatment goals for patients with Acute Myocardial Infarction are not being achieved despite a large body of evidence supporting regionalised ST Elevation Myocardial Infarction (STEMI) systems. Background: Executing a STEMI system in a pre-hospital environment varies not only from state to state but also region to region. Statewide EMS treatment protocols serve to shield an ambulance service from litigation when following the published statewide protocols. Many critical access hospitals also have standardised protocols in place for the identification and treatment of STEMI patients. We sought to understand whether these plans are followed as many system providers believe they are. If deviations were found we sought to understand the reasons for those deviations. Methods: Because all of these delay factors center around rural hospitals, the project team developed a simple online survey tool to poll the critical access hospitals of Nebraska. Results: We found that the rural STEMI care system lacks a coordinated system that is considered to be essential for urban areas. When looking at why rural STEMI patients have a higher 30 day mortality compared to patients treated in an urban environment, several areas of potential failure have been identified. Conclusion: We qualitatively demonstrated that STEMI patients in the rural setting of Nebraska are not receiving timely reperfusion even though data describing the number of persons and delays experienced are not widely tracked. Although currently lacking, individuals surveyed expressed a desire for a statewide coordinated STEMI care system.
The hospital at night: a service evaluation of the role of the paediatric night sister
Authors: Brown Karen L , Glasper Edward Alan , Newton Jan 
Published: May 2014

The objective of this evaluation was to review the role of the paediatric night sister in a large regional children’s unit in the south of England in the light of the NHS Modernisation Agency report, The Hospital At Night (Modernisation Agency, 2004). It aimed to compare and contrast the role of the traditional night sister with that of an internal rotational model. A single-site case study service evaluation was undertaken using non-participant observation of the night sister role over two full night shifts, a questionnaire, semi-structured interviews with night duty nursing and medical staff, and analysis of night sister diaries. Two full-time night sisters and 34 night nursing and medical staff took part. The review obtained a description and analysis of night sister roles, the views of staff towards the role of the night sister, an insight into enhanced skills acquisition of night sisters, and makes recommendations for future utilisation of the night sister role. Most respondents were very supportive of the traditional night sister role but were critical of the lack of collaboration between the night medical and nursing teams.
A review of nasogastric tube management in children 2: position, placement error and hydration
Authors: Clarke Sonya , Richardson Olga 
Published: May 2014

This second of two papers examines two major themes drawn from a review of the literature relating to nasogastric tube (NGT) use in children: confirmation of tube position and associated placement errors and use of the nasogastric tube for rehydration in cases of acute gastroenteritis. The NGT has been highlighted as a pertinent issue by several reports in recent years of unnecessary deaths in infants, children and adults. These culminated in February 2005 in the issuing of a high priority patient safety alert by the UK’s National Patient Safety Agency (NPSA, 2005a). This was accompanied by a range of specific guidance relating to all three patient groups. As well as providing a route for enteral feeding (the subject of part 1 of this series), the NGT has been reported as a route to provide oral hydration for children with acute gastroenteritis, and to administer medication. This review examines the research evidence relating to these themes and draws from it some recommendations for practice.
Providing support at home for families whose children have complex needs
Authors: Hewitt-Taylor Jaquelina 
Published: May 2014

This paper discusses the experiences of parents whose children have complex and continuing health needs in relation to receiving assistance to enable their child to live at home. It focuses on the provision of support in the family home and the challenges as well as benefits that this can present. The findings are taken from a qualitative study of parents’ experiences of having a child who has complex and continuing health needs. While it is a relatively small study, it contributes to an increasing body of evidence that should inform the delivery of support for children and their families. The principal findings of the study are: that despite their necessity, having staff in the family home can constitute a significant intrusion on the lives and privacy of individuals and families; the level of involvement which individuals and families prefer to have with staff varies; having staff in the family home can change the experience of parenting; and that although the provision of staff is intended to assist families, staff can of themselves increase families’ workload. These findings suggest that staff who are involved in supporting children with complex and continuing health needs and their families need to be able to work flexibly, respecting their clients’ choices regarding their home, relationships, child-care practices, and their time. They need to explore how the support provided can maximize quality of life for the child and family while minimizing intrusion.
All change in children’s and young people’s nurse education: the views of senior practitioners
Authors: Richardson Jim , Glasper Edward Alan , McEwing Gill , Ellis Judith , Horsely Angela 
Published: May 2014

The field of children and young people’s nursing practice has only existed for 18 years in its current configuration. Despite this the Nursing and Midwifery Council (NMC) as part of their mandate to consider a recommendation of the outgoing UKCC post-commission development group to consider its recommendations for the future of the pre-registration fields of practice was launched in November 2007. This consultation with the profession as a whole asks registrants to consider the UKCC post-commission group (2001) legacy of six potential changes to the way in which nurses are educated for the profession. This paper reports on a focus group activity conducted with Members of the Association of Chief Children’s Nurses (ACCN) at their autumn 2007 meeting on the Island of jersey designed to fully consider the six options from a children’s nursing perspective. As part of the consultation exercise the current NMC also consider no change to the existing register format as a discrete option in its review. (ACCN, 2007). Data in the format of a SWOT analysis was elicited from 18 members of the ACCN. An analysis of the data demonstrates that senior children’s nurses firmly believe in retaining discrete children’s and young people’s nursing field of practice at the pre-registration level.
Information-seeking experiences of fathers of children with cystic fibrosis
Authors: Hayes Claire 
Published: May 2014

In the early years following the diagnosis of their child with Cystic fibrosis (CF) fathers need information on a range of subjects including medication; specific dietary requirements; chest physiotherapy and signs and symptoms of the disease process to manage their children’s day-to-day care. The aim of the study was to explore fathers’ experiences of seeking information on CF. Following ethical approval, tape-recorded interviews were conducted with eight Irish fathers of children with CF aged one to six years. Data were analysed manually using thematic content analysis. Rigour of the study was established through the use of verbatim quotations, reflexivity and a decision trail of the research process. Fathers sought information specific to their children’s health from health professionals. In addition, they described accessing various media sources such as books, newspapers, television and the Internet for the latest scientific and research information. They identified other parents of children with CF as a source of practical knowledge. For some fathers however the pursuit of information lost momentum over time and this seemed to be influenced by the perpetual negative information available to them. Seeking information is a positive response to caring for children with CF. Health professionals need to support and facilitate fathers searches and provide information that is timely and relevant to their individual needs.