bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Analytic System of Moscow Register of Education Quality as a Powerful Tool of Managerial Activities Within the Educational Complex
Authors: ����������  , Kurchatkina Irina 
Published: May 2014

Large-scale educational institutions produce additional resources for educational environment development, for enriching range of educational services,
and are especially conducive to enhancing capacities of personality-oriented learning, nurturing competencies, necessary for informed choice of
profession, and for better perspectives of education in general. However, this generate a new set of risks � mainly of psychological nature � typical
to the situation, when diverse teams of teaching staff and students have to merge, as well as risks of managerial origin, as a result of new set of tasks
come around and renovation of the organizational mission. We assume that each educational institution to be integrated in the educational complex, is
unique. And we believe that each item of best practices must be preserved and at the same time developed at the new level through setting and meeting
new objectives and implementing up-to-date projects. And all the necessary resources and opportunities for this are available.
Strategic directions for strengthening nursing and midwifery services
Authors: Phiri Margaret Loma 
Published: May 2014

In May 2001, the World Health Assembly (WHA) adopted a resolution requesting the Director General rapidly to prepare the plan of action for strengthening nursing and midwifery services 2002–2008, known as strategic directions in support of WHA resolution 54.12 on strengthening nursing and midwifery (SDNM). The main purpose of the SDNM is to support efforts to scale up national health systems' capacity in order to meet health goals set by member states in priority areas, including: HIV/AIDS; maternal and infant health; tuberculosis; malaria; adolescent health; mental health; and chronic illnesses. The SDNM will also contribute to the achievement of WHO strategic directions which are: reducing excess mortality, morbidity and disability in populations; promoting healthy life styles and reducing risk factors; developing health systems that equitably improve health outcomes; and framing enabling policies. The purpose of this article is to provide an overview of the SDNM, progress made in their implementation and the developed regional guidelines to accelerate action at country level.
The modified WHO partograph: do we need a latent phase?
Authors: Kwast Barbara E. , Poovan Pia , Vera Edita , Kohls Elaine 
Published: May 2014

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

Background and aims:Maternal and newborn mortality in most sub-Saharan African countries, such as in Ethiopia, remains unacceptably high; the maternal mortality rate is 470 per 100 000 live births. This study aimed to establish why maternal and newborn mortality remains so high in rural Ethiopia.Methods:For a consecutive period of 3 weeks all pregnant women requiring emergency obstetric surgery at a rural district hospital in Ethiopia were surveyed. Patients already admitted in the hospital and/or waiting planned or urgent caesarean sections were excluded from this study. To establish the main bottle neck areas of concern to reduce maternal and/or neonatal mortality, a survey of woman's journey from home to operating table was carried out in a district hospital in Ethiopia. Thirty-six pregnant women who required emergency obstetric operations due to serious complications in pregnancy were included in the study.Results:The most common obstetric problems observed were obstructed labour (80%), eclampsia, antepartum and postpartum haemorrhage. The average time taken from the decision to transfer and arrival at a hospital was 5.5 hours. Two mothers and 26 babies did not survive; 3 women developed vesico-vaginal fistula. Of the 36 women, 9 had hysterectomy for ruptured uteruses. The average costs to the family for transport and for hospital treatment were US$63—the average annual family income in Ethiopia is only around US$180.Conclusion:Complications in pregnancy in rural Ethiopia lead to poor outcomes. The major causes of these are failure to diagnose complications early due to the lack of appropriate healthcare available locally and when diagnosed, in the delay of transfer to hospital for intervention.
Poor pregnancy outcomes in public health facilities in Kenya
Authors: Cheptum Joyce Jebet , Oyore John Paul , Okello Agina Bonaventure Michael 
Published: May 2014

Background: Addressing poor pregnancy and childbirth outcomes such as still births, pre-term births and neonatal deaths have continued to be a major global challenge. Nations and organisations have invested much effort and resources to promote safe pregnancy and childbirth. Objective: To identify factors contributing to adverse pregnancy outcomes among women seeking care in public health facilities in the Keiyo district of Kenya. Methods: A descriptive cross-sectional design was used employing both quantitative and qualitative methods. Three hundred and eighty four women of reproductive age (15–49 years) attending public health facilities for Maternal and Child Health/Family Planning (MCH/FP) were interviewed. Results: There are several factors which cause adverse pregnancy outcomes. Socioeconomic and demographic factors that were associated with poor pregnancy outcomes include low education level, lack of formal employment and multiparity. Other factors included pre-term birth, preexisting medical conditions, illnesses during pregnancy and obstetric emergencies. The lengthy referral pattern also was a contributory factor. Conclusions: There are several factors that contribute to poor pregnancy outcomes. Social mobilisation of the community on reproductive health issues should be done through health education to enhance proper basic obstetric care and emergency obstetric care. Health facilities should be well staffed and well equipped in order to avoid poor pregnancy outcomes, which may occur as a result of delays owing to lack of staff or equipment. There should be a well defined referral system to enable timely referrals.
Heart disease and erectile dysfunction: Management at a nurse-led clinic
Authors: Steggall Martin J , Butler Jane , Coals Sally , Chinegwundoh Francis I 
Published: May 2014

Background: Erectile dysfunction has an estimated prevalence of 10% in all sexually active men. Aetiological features include neurovascular disease and psychological distress. The authors’ clinical impression was that men with hear t disease were not offered any intervention for erectile dysfunction at all whereas men with prostate disease were.Aim: To per form a retrospective analysis of men who had sought treatment for erectile dysfunction at the east London nurse-led sexual dysfunction clinic in the last 22 months.Methods: A retrospective comparative analysis was made of the time it took different groups of men to seek treatment. The authors identified 96 patients who met the inclusion criteria for a diagnosis of erectile dysfunction. A search of all clinical notes of men seen in the erectile dysfunction clinic was conducted by hand.Main outcome measure: Demographic and clinical data were collected from the clinical notes. The source of referrer, previous treatment and reasons for delay in seeking treatment were identified. The data were compared with men presenting to the same clinic but with a history of prostate cancer treatment only.Results: The mean age of men attending the clinic for advice was 62.2 years and 61% of patients with cardiac disease and 5% with prostatic disease had not tried any treatment for erectile dysfunction. After referral and assessment only 12% declined active therapy for erectile dysfunction.Conclusions: On average men who attend the clinic for advice had not had successful sexual activity for about 41.7 months. The reasons cited for delay in seeking help were embarrassment and because the subject was not brought up by health professionals. The authors believe that the subject of erectile dysfunction should be broached with patients, and referral pathways should be developed to facilitate an improvement in sexual function.
Diagnosing and treating Brugada syndrome
Authors: Firman Eileen 
Published: May 2014

The inclusion of Chapter 8 in the Coronary Heart Disease: National Service Framework for Coronary Heart Disease: Modern Standards and Service Models (DH, 2005) has highlighted conditions that cause sudden death in young people. Brugada syndrome is an inherited genetic condition involving the cardiac sodium channels and the clinical presentation, ECG abnormalities and treatment are discussed in this article. Progress in the field of molecular genetics and the mapping of the SCN5A gene has resulted in the potential for genetic testing not only to help in diagnosis of an affected patient or deceased relative, but in predictive testing of family members. The psychological impact of the disease on families and the role of the nurse are also explored.
Setting up a primary percutaneous coronary intervention service
Authors: Nicholas Marina 
Published: May 2014

Primary percutaneous coronary intervention (PPCI) has been shown to be the most effective treatment in restoring the coronary blood flow of patients with an ST-segment elevation myocardial infarction (STEMI). PPCI has also been shown to have better long-term survival rates, result in fewer non-fatal re-infarctions and cause fewer haemorrhagic strokes compared to patients treated with thrombolysis. It is only in the last 3 years that the government has decided to pilot the feasibility and cost-effectiveness of developing a nationwide PPCI service. This paper describes how a tertiary centre for cardiac services set up a 24-hour PPCI service and some of the problems that occurred. It also discusses the protocols and guidelines that were developed and issues around bed management and staffing levels. This paper also considers the educational needs of the staff, cost implications of this service and the impact this service had on the cardiac rehabilitation department.
Patient education before undergoing percutaneous coronary intervention
Authors: Chair Sek Ying , Pang Anita Mei Hing 
Published: May 2014

Aim: This study aimed to evaluate whether a preoperative education programme could improve patients’ knowledge level and satisfaction level related to the procedure of percutaneous coronary intervention (PCI). Methods: The study used a pre- and post-intervention test design.A structured preoperative education programme was offered to 70 patients undergoing PCI at a private hospital in Hong Kong. Patients’ knowledge regarding PCI was assessed before the teaching programme on the admission day and the morning before the procedure. Patients’ satisfaction level was assessed before discharge from the intensive care unit. Results: A statistically significant difference was found between the patients’ knowledge base before and after the teaching programme (t=28.9, P<0.001). Moreover, a patient satisfaction survey was developed and yielded very positive results. Conclusions: With the younger age and increased educational level of cardiac patients in the last decade, the demand for in-depth and detailed information of the disease and treatment modalities are expected to increase. A preoperative teaching programme would increase patients’ knowledge of the PCI procedure and promote patient satisfaction regarding the care received.
The therapeutic benefits of rosuvastatin
Authors: Hoey Sarah 
Published: May 2014

Rosuvastatin, one of the drugs in the statin class of medicines, is licensed in the UK for primary hypercholesterolaemia in patients where non-pharmacological methods such as weight reduction and exercise have proved inadequate. It offers a second-line therapy for patients whose cholesterol has not been controlled on simvastatin or atorvastatin plus ezetimbe This article discusses the pharmacological properties and prescribing considerations for the drug.
Vascular access and cardiac complications after PCI: In- and out-of-hospital outcome issues
Authors: Higgins Monica , Theobald Karen , Peters Jaime 
Published: May 2014

Background: Despite the rapid increase in percutaneous coronary intervention (PCI) rates, vascular complications remain a possible source of impaired outcomes for patients. Moreover, management of complications is an integral part of cardiac nurses’ roles and responsibilities. Aim: The aim of this quality review was to highlight the in-hospital and out-of-hospital complications up to 12 months post-discharge following PCI. Methods and Results: A review of prospectively-collected data from the Angioplasty Database run by the research institute of 1089 consecutive patients who had PCI procedures from 1 January 2005– 31 December 2006 was conducted. The in-hospital vascular complications included bleeding/ooze only (22.4%) and haematoma only (7.1%). The in-hospital cardiac outcomes included one death(0.09%) following PCI. In addition, a sample of 525 (52%) patients were followed up at 1 month and 12 months post-procedure. Vascular complications were 2.5% and 4% respectively. Cardiac complications included repeat angiogram (9.7%) and repeat PCI (3.6%). Conclusions: Vascular outcomes pose ongoing problems for patients both in and out of hospital. The results suggest that cardiac nurses need to further improve monitoring of their patient outcomes following PCI.
Patient education around cardiac surgery
Authors: Goodman Helen 
Published: May 2014

This article considers the content and format of patient education before cardiac surgery, with a review of the literature on patients’ needs at this time, and previous methods used. Patient education has long been an important part of nursing care. However, time pressure such as the 18-weeks target from GP referral to surgery and the need for more patients to be prepared in a shorter time frame should prompt nurses to review how information is presented and provide it in a timely and effective manner. There is a need to ensure that a wide approach is taken to education including details of the operation and admission process but also the reason for the operation and the nature of heart disease. This should include addressing misconceptions and providing the opportunity for individual questions and concerns to be addressed.
Central venous oxygen saturation monitoring
Authors: Ladewig Emma L , Lewis Peter A 
Published: May 2014

It has been established that mixed venous oxygen saturation (Svo2) reflects the balance between systemic oxygen delivery and consumption. Literature indicates that it is a valuable clinical indicator and has good prognostic value early in patient course. This article aims to establish the usefulness of Svo2 as a clinical indicator. A secondary aim was to determine whether central venous oxygen saturation (Scvo2) and Svo2 are interchangeable. Of particular relevance to cardiac nurses is the link between decreased Svo2 and cardiac failure in patients with myocardial infarction, and with decline in myocardial function, clinical shock and arrhythmias. While absolute values Scvo2 and Svo2 are not interchangeable, Scvo2 and Svo2 are equivalent in terms of clinical course. Additionally, Scvo2 monitoring is a safer and less costly alternative to Svo2 monitoring. It can be concluded that continuous Scvo2 monitoring should potentially be undertaken in patients at risk of haemodynamic instability.
An evaluation of a primary and secondary care cardiac rehabilitation service pathway
Authors: Trotman-Beasty Anita , McKenna Jim , Ingle Lee 
Published: May 2014

Background: The aim of the study was to assess the synergy between patient treatment pathways in two large primary care trusts (PCTs) and general practices for patients following myocardial infarction (MI) and after completing a 12-week cardiac rehabilitation (CR) hear t manual programme in Kingston-Upon-Hull and the East Riding of Yorkshire. Methods: Of the 50 practice nurses randomly selected from local GP surgeries and invited to participate, 40 questionnaires were returned and two practice nurses volunteered to be inter viewed. Results: Four key themes were identified: knowledge of the ‘heart manual programme’ (HMP); information received or used post-HMP; post-MI follow-up routines of practice nurses; the practice nurse: assessment. Conclusions: It appears that current CR provision in Kingston-uponHull and the East Riding of Yorkshire may be fragmented and duplicative, leading to poor cost effectiveness as both primary and secondary care providers are working to conflicting government targets. The system fails to build on the strengths of the health professionals working within it. We recommend the development of an integrated, standardized care pathway that we hope will bring a ‘joined-up’ solution to a disjointed problem.
Spotting early signs of depression in patients with chronic heart failure
Authors: Kirk Mary , LeGeyt Paulette 
Published: May 2014

Depression tends to be more common in patients with heart failure than in the general population. It is estimated to affect between 24% and 40% of patients with stable heart failure. Loss of a patient’s sense of self and a forced change in lifestyle can be difficult to accept and that in turn can lead to low mood and then depression. Other factors such as previous mental health issues and external stressors can influence the risk of depression. Evidence suggests depressed patients are less likely to adhere to medication and lifestyle regimes thereby increasing the likelihood of deterioration in their cardiac condition. Fatigue and poor sleep patterns are symptoms associated with heart failure, but can also be attributable to depression. This could influence health professionals’ assessment and treatment of patient’s heart failure, while not addressing the underlying issue of depression. This article looks at depression in heart failure patients and suggests ways in which health professionals can identify early those patients that have an increased risk of developing depression.
Rheumatoid arthritis and risk factors for cardiovascular disease
Authors: Kumar Namita 
Published: May 2014

The fact that patients with rheumatoid arthritis have an increased risk of cardiovacular disease is now without doubt. There are multiple risk factors that could be blamed for this increased incidence. The traditional risk factors well known to us all may be to blame in part but there are other, more novel, risk factors that are more relevant in rheumatoid arthritis. This paper aims to discuss some of these less well-known risk factors for CVD particularly with regard to rheumatoid arthritis. Treatment strategies are also discussed.
Aquapheresis: a therapeutic option for fluid-overloaded patients
Authors: Wick Caroline , Bakhai Ameet 
Published: May 2014

Heart failure is one of the most common causes of hospital emergency admissions (5%), re-admissions and bed day occupancy, and these rates are predicted to increase in the future. Of all heart failure admissions, 90% are due to fluid overload. Currently, loop diuretics are the ‘hallmark’ treatment, however some patients become resistant to diuretic therapy over time and diuretics have a high rate of adverse effects. Considering the large number of patients, increased morbidity, mortality rates and resource use, current management strategies are not optimal: new therapies are required and should be evaluated thoroughly. Aquapheresis (AQ) is a non-pharmacological procedure that removes excess water and sodium from the blood via a filter using a simplified ultrafiltration (UF) device. This article discusses AQ as a treatment option. AQ is a relatively new therapy in the UK and has some advantages over conventional therapy. In particular, patients can be treated with AQ in a cardiology setting, this may allow rapid removal of excess fluid and earlier discharge. Close consultant supervision and input is required with dedicated nursing staff managing the patient. A formal UK health economic analysis is required. AQ provides a feasible, additional treatment option for patients with heart failure in the UK, which are significantly limited at present.
Delirium in cardiac patients: A clinical review
Authors: Clegg Andrew , Young John , Siddiqi Najma 
Published: May 2014

Delirium is a common but preventable clinical syndrome that is distressing for patients, relatives and staff. It occurs frequently on cardiac wards and is associated with important adverse health consequences. In cardiac surgery patients, important preoperative risk factors are presence of cognitive impairment, depressive symptoms, previous stroke or transient ischaemic attack and abnormal albumin. Nursing staff are particularly well placed to facilitate the diagnosis of delirium, which should be suspected if a patient has a rapid onset of fluctuating confusion. The Delirium Observation Screening (DOS) tool has been developed for use by nursing staff during routine ward care to identify delirium. The initial management of delirium involves identification and treatment of the potential cause, or combination of causes. People with delirium may have impaired capacity to consent and health-care professionals who care for people with delirium should therefore be familiar with the assessment of mental capacity.