bluuebunny/crossref_metadata_2025_split huggingface dataset:
Students’ perspectives on their skills acquisition and confidence
Authors: Meechan Ronnie , Jones Helen , Valler-Jones Tracey 
Published: May 2014

Aim: To investigate students’ perspectives on their skills acquisition and knowledge during the foundation year of their nursing programme, and whether this improved students’ levels of competence and confidence. Method: Two groups of nursing students (n=140) responded to a clinical acquisition skills survey (CASS) to elicit their perceptions of clinical skills acquisition. Additionally, students’ competence levels were examined, drawing comparisons with the students’ objective, structured clinical examination (OSCE) results. Results/Findings: Students identified that the curriculum supported the acquisition of clinical skills, and clinical examination results confirmed that 95% of students were competent to pass their OSCE. Conclusion: Students’ responses to items that related to perceived confidence and competence levels were positive. This indicates that the introduction of clinical skills teaching and assessment within a university's simulation suites augmented with structured assessment within the clinical environment improved the acquisition of clinical skills.
Coronary artery bypass grafting: quality of life of patients in Karachi
Authors: Barolia Rozina , Ali Fauziya , Jaffar Salma , Sami Shahid 
Published: May 2014

In the Third World, cardiac patients often suffer not only from the nature of their illnesses, but also the insufficiency of the facilities available. Although the effectiveness of coronary artery bypass grafting (CABG) is being evaluated in terms of mortality, complications or recurrence of symptoms, empirical studies assessing the change in patients' quality of life (QOL) after CABG within the Pakistani cultural context are lacking. Aims: The aims of the present study are to assess and compare the change in health-related quality of life before and 1 month after CABG and to assess the differences in QOL with respect to age, gender and cardiac rehabilitation programme attendance. Method: A prospective single group pre- and post-study design was used, whereby patients completed a questionnaire before and 1 month after surgery. Questions considered the person's physical capacity, psychological wellbeing, social relationships and satisfaction from their health condition. Results: The results indicated a significant improvement in patients' physical and psychological health, satisfaction with social relationships and overall health status. Younger patients showed significantly lower scores on the social domain (reflecting greater dissatisfaction with their sex life and personal relationships). Female participants showed significantly lower scores in psychological health post surgery. Lastly, participants of the cardiac rehabilitation programme scored significantly higher in psychological health compared with non-participants. Conclusion: QOL improved from prior to and 1 month after CABG while differing (in specific domains) with respect to age, gender and cardiac rehabilitation programme attendance. The findings can be used to develop interventions to improve health and QOL in specific domains with respect to specific groups.
Impact of formal educational level on clinical specialist role activity
Authors: Wickham Sheelagh 
Published: May 2014

Aims: This study, set in Ireland, aimed to explore demographics of the clinical nurse specialist and clinical midwife specialist population and their role activity, particularly in the educational role. Background: The clinical nurse/midwife specialist is recognised as an important part of nursing today. In Ireland, formal recognition of the specialist role occurred as recently as 2001. Methods: Following ethical approval, a questionnaire was circulated to the total population of specialist nurses and midwives in Ireland. The questionnaire captured the formal educational level held and individual educational role activity. Results: The study articulates the individual educational role elements (e.g. patient education, peer education) and captures the level of activity but the level varies between different educational role elements. Formal education level held has an impact on role activity, with higher education levels resulting in greater activity levels. Conclusions: The clinical specialist has tremendous potential for a positive impact on patient care in his or her education role. The majority are active in this role but the analysis shows there is room for growth. Combined with the finding that the level of activity rises with the level of formal education, this gives a strong reason why there should be continuing focus on further education and life-long learning
Problems with use of a Foley catheter in enteral tube feeding
Authors: Ojo Omorogieva 
Published: May 2014

This article discusses the unlicensed use of a Foley catheter in home enteral tube feeding in the community. It is now clear that patients on long-term enteral feeding in the community may require replacement of their feeding tubes due to deterioration, damage or tube dislodgment. Often, these conventional feeding tubes such as percutaneous endoscopic gastrostomy and radiologically inserted gastrostomy tubes are replaced with similar tubes or with balloon gastrostomy tubes. However, the use of a Foley catheter in place of conventional feeding tubes as replacement tube has been observed in a number of patients in practice and documented in literature. The Foley catheter is significantly less expensive and easily accessible than conventional feeding tubes or balloon gastrostomy tubes. However, its use as an enteral feeding tube has implications for practice in terms of its use as unlicensed product, consent, ethics and professional responsibilities. Issues relating to body image and quality of life are also discussed.
Development of the role of the practice teacher
Authors: Sherwin Sarah , Stevenson Liz 
Published: May 2014

The role of the practice teacher is pivotal in supporting the development of students undertaking Nursing and Midwifery Council (NMC) approved Specialist Community Public Health, School Nursing (SCPHN) programmes. It is a mandatory requirement that students of school nursing are supported and assessed by a named practice teacher, who must have met the requirements defined within the practice teacher standard (NMC, 2008). In this series of short papers, Sarah Sherwin and Liz Stevenson explore the developing role of the practice teacher in relation to school nursing, since the advent of the revised standards. Although specifically geared towards practice teachers within the school nursing arena, mentors who provide support to a range of students within the community health setting may also find the series useful.
Developing health services designed for young people
Authors: Tall Hannah 
Published: May 2014

The Healthy Child Programme sets out an evidence-based, preventive programme supporting current research which demonstrates lifestyles and habits established during childhood, adolescence and young adulthood influence a person’s health throughout their life. Healthy Lives Brighter Futures identifies the importance of targeting services toward young people, ensuring they receive high quality support and advice on making healthy choices such as alcohol, drugs, smoking, sexual health. During the developmental stage of adolescence young people strive for independence and begin to make decisions that impact on the rest of their lives. School nurses are skilled in leading teams that promote health improvement. They working within a progressive model where services are both universal and targeted towards those with specific needs. If young people are involved in service design and delivery they are more likely to access services and promote them within their peer group. Consultation with young people also allows effective evaluation of the service ensuring quality is maintained and service delivery improved. The article explores the role of the school nurse when involving young people in service development and the implications this has for future practice.
Symptoms and treatment of menorraghia in adolescent girls
Authors: Perry Margaret 
Published: May 2014

The onset of menarche can be a difficult time for adolescent girls. Menorraghia is a condition consisting of excessive menstrual bleeding over an extended period of time. Although rarely life-threatening, the condition can affect quality of life and participation in school activities and sport. School nurses can play an important role in providing information and advice on the condition. This article is part of a series looking at male and female puberty issues, it provides an overview of menorraghia, including prevalence, symptoms and treatment.
Refractive errors among 7–16 year old children
Authors: AlBashtawy Mohammed , Hameed Sinan , Mansi Kamal , Aljezawi Ma'en , Tubaishat Ahmad 
Published: May 2014

Objective: This study aims to help school nurses gain a better insight into the prevalence of refractive errors (RE) in children in the Mafraq Governorate, and how it compares with other Jordanian provinces and internationally. Methods: A cross-sectional survey was carried out to assess visual acuity and refractive errors among school children in Mafaraq-Jordan. Subjects were chosen using a multistage random sample. Children in grades one through ten in the selected schools were interviewed using a standard questionnaire. Visual acuity was screened using Snellen chart. Results: 1 303 school children completed all the process of the screening and completed the questionnaire. A total of 1 230 (94.4%) had normal visual acuity without any correction, 73 children (5.6%) had RE, and 42 children (3.2%) tested for low vision. Conclusions: Results from this study showed a considerable number of school children with RE. Accordingly, screening programmes for visual acuity should be conducted in all schools at the beginning of each academic year.
Reducing secondhand smoke exposure at home
Authors: Jones Laura , McEwen Andy 
Published: May 2014

Children's secondhand smoke (SHS) exposure remains a significant public health concern. In the UK, over half of children who live with smokers are regularly exposed to SHS at home. School nurses are well placed to raise the issue of SHS exposure, explain the benefits of creating smoke-free environments, and help with practical advice. This article looks at the impact of secondhand smoke exposure and a training module available to school nurses, which aims to help them acquire the knowledge and skills required to intervene effectively with anyone who smokes and cares for children.
Managing risk-taking behaviour in children and young people with ADHD
Authors: Mall Madan , King-Hill Sophie , Holland Paul 
Published: May 2014

Attention deficit hyperactivity disorder (ADHD) in school-aged children and young people is often associated with risky behaviours such as sexual risk-taking, drugs and alcohol misuse, and engaging in high-risk activities that may lead to physical injury. This article looks at the potential causes and effects of risk-taking behaviours children and young people with ADHD may engage in, drawing on evidence and case studies from the authors’ research. The article also provides an overview of strategies that can be adopted to help reduce these types of behaviours.
Supporting young women with oligomenorrhea
Authors: Perry Margaret 
Published: May 2014

The onset of menarche can be a difficult time for adolescent girls. Oligomenorrhea is a type of menstrual irregularity which can present among young women. It consists of menses that occur at intervals that are longer than 35 days. School nurses can play an important role in providing information and advice on the condition. This article is part of a series looking at male and female puberty issues, it provides an overview of oligomenorrhea, including causes, symptoms and treatment.
Assessing the validity and reliability of the ‘Health Dialogue’ in 10-year-olds
Authors: Holmström Malin Rising , Olofsson Niclas , Kristiansen Lisbeth 
Published: May 2014

Aim: The aim was to assess the concurrent, construct and convergent validity of the Health Dialogue questionnaire (HD) in 4th grade in compulsory school, through comparison of the HD questionnaire with Pediatric Quality Of Life Inventory (PedsQL), and Health Behavior in School-aged Children (HBSC). Methods: A sample was created from the HD n=1956, HBSC, n=1500 and PedsQL n=425. An exploratory factor analysis was performed in order to evaluate the construct validity of HD. Results: A majority of the questions show acceptable concurrent validity and the results support the HD as a valid 16-item three factorial model for school children aged 10 years old (grade 4). The HD's three factorial model's degree of explanation was 39% of the school children's health in school settings. Conclusion: The HD questionnaire is a valid instrument for measuring 10-year-old school children's self-reported-health and to identify positive health factors.
Bathroom safety considerations for clients with a disability and their carers
Authors: Hall Debra 
Published: May 2014

The bathroom is used on a frequent basis for a range of activities of daily living. However, the bathroom environment presents many hazards which carers and residents must be aware of. This article outlines some of the dangers that could impact on the safety of clients with a disability and their carers. Some suggestions to reduce risks and improve safety are given. Features such as mobility aids are also discussed, which relieve the burden on carers and increase client independence. This article is designed as a guide for health-care professionals who provide personal care to vulnerable clients.
Impact of cognitive impairment on hip fracture outcome in older people
Authors: Frances Horgan N , J Cunningham Conal 
Published: May 2014

Hip fracture is common in older people and often leads to increased levels of disability and mortality and increased functional impairment. Cognitive impairment is also common and has been suggested to influence hip fracture outcome. This study evaluated the impact of cognitive impairment on functional outcome in older patients with femoral hip fracture, and patients' responses to a standard acute inpatient physiotherapy programme. Patients aged 65 years and older who underwent surgery for hip or upper femoral fracture were studied. Cognition was assessed using the Abbreviated Mental Test Score (AMTS) and mobility was measured using the Elderly Mobility Scale (EMS). Patient details and duration of physiotherapy treatment were recorded. Moderate to severe (although not mild to moderate) cognitive impairment had a strong negative impact on functional outcome and discharge, which was independent of the amount of physiotherapy received. An increased understanding of the complex relationship between cognition, ambulation and rehabilitation outcome is required and poses a significant challenge to health-care professionals.
An analysis of the intervention provided by a stroke family support organizer service
Authors: Groom Madeleine J , Lilley Steven A , Francis Valerie M , Lincoln Nadina B 
Published: May 2014

This article describes the input of a stroke family support organizer (FSO) service and investigates whether patient needs are directly related to the number and nature of FSO contacts. Patients seen by the FSO for more visits were significantly younger, less disabled before the stroke, more disabled at recruitment and with lower mood than those with fewer contacts. Significant relationships were found between the amount of contact that involved discussion of benefits and knowledge of benefits, and between discussion of physical health and knowledge of prevention of future stroke. The FSO provided useful information about benefits and physical recovery following stroke.
Competence in on-call physiotherapy part two: developing an assessment tool
Authors: Cross Jane , Harden Beverly , Thomas Sandy , ten Hove Ruth 
Published: May 2014

The Association of Chartered Physiotherapists in Respiratory Care (ACPRC) identified concerns among its members regarding perceived variability of practice in the delivery of on-call physiotherapy. They responded by developing a national set of guidelines on competence and its assessment in cardiorespiratory physiotherapy. The second part to this article develops the issues surrounding the provision of on-call services within the physiotherapy profession. It demonstrates how the ACPRC and the Chartered Society of Physiotherapy used the standards of the profession to develop a tool to help individuals and organizations address the issues of developing and maintaining competence within this particular setting.
Buying a practice microscope
Authors: Scarff David H. 
Published: May 2014

A good-quality microscope is an essential part of the equipment of a veterinary general practice. It is a precision instrument and needs to be treated as such but, with care, can last for many years. There has never been so much choice in the number of microscope models available but choose carefully, as it is true that you get what you pay for. There are a number of options available that can improve the performance of the instrument and make its use more comfortable for the operator. This article, the first in a three-part series, will provide advice on choosing a practice microscope. The second and third articles in this series will cover routine microscope set-up and maintainece, and digital photography through the practice microscope
Metastatic prostate cancer presenting as diplopia with regression of signs with hormone manipulation
Authors: Kumar P , Duarte J , Pati J 
Published: May 2014

A 73-year-old man presented with sudden onset diplopia. He was referred to the ophthalmology team who thought he had a VIth nerve palsy. He subsequently underwent computed tomography (CT) (Figure 1) and magnetic resonance imaging (Figure 2). These images revealed a mass occupying and expanding the sella with extension inferiorly to the sphenoid sinus. The clivus was almost completely replaced by tumour. The cavernous sinuses were involved bilaterally but the optic chiasm was not involved. It was thought that these finding were consistent with an unusual invasive pituitary tumour and surgical excision biopsy was undertaken. The histology was consistent with metastatic carcinoma of the prostate. His prostate-specific antigen (PSA) taken post-histology was 382 μg/litre and a bone scan confirmed metastases in the ribs, thoracic and lumbar spine, sacrum, left sacroiliac joint, ilium, ischium and pubis. He was subsequently started on luteinizing hormone-releasing hormone analogues which brought about a resolution of his diplopia. Follow-up CT of the head revealed regression of the skull base mass. At 18-month follow-up he remains well with no visual impairment, the PSA having decreased to >0.2 μg/litre.
Giant cell arteritis presenting as painful third nerve palsy with normal erythrocyte sedimentation rate
Authors: Madge Simon N , Klys Howard , Twomey John M 
Published: May 2014

An 80-year-old man was referred to hospital with a 2-week history of headache and 1 day of vertical diplopia, but was systemically well with no symptoms of giant cell arteritis (GCA). Past medical history included right central retinal vein occlusion, for which he had previously received panretinal photocoagulation. His full blood count and blood glucose were normal, erythrocyte sedimentation rate (ESR) 24 mm/hr and C-reactive protein (CRP) 34 mg/litre. Two days later, an ophthalmological review was requested. The visual acuity was 6/36 right eye and 6/9 left. There was a moderate exotropia with diplopia and a left ptosis with restriction of both elevation and adduction of the left eye; depression of the left eye was normal. The left fourth nerve appeared intact. Neither optic disc appeared swollen. In view of the painful left partial third nerve palsy, urgent magnetic resonance angiography was performed but showed no significant abnormality, suggesting a microvascular cause. A Fresnel prism was fitted to his spectacles with resolution of diplopia. Three weeks later, his symptoms had resolved. Although he remained well and had no symptoms of GCA, his left superficial temporal artery was markedly swollen, albeit non-tender. His ESR was 25 mm/hr and CRP 30 mg/litre. In light of his unusually rapid recovery, a diagnosis of atypical GCA was made and prednisolone started. Temporal artery biopsy confirmed GCA (Figures 1 and 2).
Femoral nerve injury following oophorectomy
Authors: Kumar B , Chandra K , Kapoor Tina 
Published: May 2014

A 46-year-old woman attended the gynaecology clinic complaining of right iliac fossa pain and dyspareunia of 18 months duration. Her symptoms were gradually worsening. She had a history of hysterectomy and left salpingoophorectomy for menorrhagia caused by fibroids. The patient had a body mass index of 29. Bimanual pelvic examination revealed right adnexal fullness which was confirmed on ultrasound scan to be an ovarian cyst. After appropriate counselling a right oophorectomy was planned. The procedure was performed through a transverse suprapubic incision. During the operation the abdominal wall was held apart with a self-retaining retractor. It was not necessary to open the retroperitoneal space because the ovary was lying adherent to the vaginal vault peritoneum. The procedure was uneventful. In the immediate postoperative period she complained of pain in the right anterior and medial aspect of the thigh. She also showed signs of significant intraperitoneal bleed and developed mild haematuria. Repeat exploratory laparotomy was performed to stop haemorrhage. On the fourth postoperative day she fell down when attempting to walk. She described pain and numbness in the right anterior thigh extending from the inguinal crease and distally to the knee and slightly below the knee on the lateral border. Following recovery from surgery a specialist neurological examination showed weakness of right hip flexion and knee extension, absence of the right knee jerk, and anaesthesia over the anterior and medial aspects of the right thigh. A right femoral neuropathy, presumed secondary to the surgical procedure, was diagnosed. Peripheral neurophysiological studies showed acute denervation of the right vastus lateralis with a marked loss of motor units confirming the clinical diagnosis. The patient started physiotherapy and was treated with amitryptiline and tramadol for her pain. After 8 months there was appreciable improvement in her symptoms. She was started on gabapentin and remains under follow up in a pain clinic.
Giant cell arteritis: not just a stroke in the eye
Authors: Borg Frances A , Dasgupta Bhaskar 
Published: May 2014

Giant cell arteritis is a large vessel vasculitis with predilection for the cranial arteries. However, as illustrated by two case reports in this month's issue (p. 650 and 651), involvement of large vessels, such as the aorta, is increasingly recognized. It is the commonest systemic vasculitis of the elderly, almost exclusively seen in those of over 50 years of age. There is a female preponderance and geographical variation in prevalence, with higher frequency in Caucasians than in other ethnicities. The incidence in the UK is 2.2/10 000 person-years.