bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological assessment of facial features in patients with cerebrovascular disease
Authors: Ito Keiichi , Shiraishi Kazuko , Iseki Hiroshi 
Published: May 2014

Objective: In the treatment of post-acute cerebrovascular disease it may be possible to assess the consciousness levels of patients who have difficulty communicating by evaluating changes in facial features. To determine the usefulness of changes in facial features for assessment in neurological nursing, the correlation between the process of recovery from consciousness disturbance and the facial features of patients with cerebrovascular disease was investigated. Methods: Using a tool for facial image processing, the average faces of three patients with cerebrovascular disease were produced and the nurses then instructed to describe the characteristic changes in facial features associated with the process of recovery from consciousness disturbance. Results: As patient consciousness levels improved, facial features such as eyelid muscles, mouth muscles, and orofacial contours changed, owing to improved motor function of the mandibular bone. Changes in facial features are useful for assessment in neurological nursing. Conclusions: These findings could form the foundation for nursing research on facial assessment involving greater numbers of subjects.
Longer term rehabilitation for patients following stroke: A literature review
Authors: McIntyre Melanie , Mitchell Elizabeth A 
Published: May 2014

Stroke remains the main cause of severe disability in the UK with approximately one third of stroke survivors functionally dependent at 1 year after a stroke. Early access to cognitive and physical rehabilitation therapy after stroke is considered to be a hallmark of effective stroke services but evidence is also emerging to support longer term rehabilitation for these patients. This paper explores the evidence base for cognitive and physical rehabilitation therapy for patients 6 months or later after stroke. Intensively applied interventions appear to mediate more positive and sustained outcomes. Group interventions can be an efficient way to maximize intensity. All professions have a responsibility to ensure that practice is evidence based. In light of a paucity of quality research in rehabilitation interventions, it is incumbent on health professionals, service users and researchers to work together to study longer term rehabilitation in a more rigorous manner.
Sharing information with patients like me
Authors: Wicks Paul 
Published: May 2014

Patients LikeMe.com is an online health community which creates new knowledge by charting the real-world course of disease through the shared experiences of patients with: ▪ Motor neurone disease (MND) (or amyotrophic lateral sclerosis (ALS)) ▪ Multiple sclerosis ▪ Parkinson's disease ▪ HIV ▪ Mood conditions (including depression and bipolar, anxiety, obsessive-compulsive and posttraumatic stress disorders) ▪ Fibromyalgia.
Autopsy trends in head injury: Understanding the benefits and potential for alternatives
Authors: Outtrim Joanne 
Published: May 2014

In recent years the UK has seen a number of public scandals regarding the unauthorized removal and retention of human organs and tissue. This has contributed to an already decreasing rate of hospital autopsy. Deaths from traumatic brain injury must legally be subject to a coronial investigation to confirm cause of death. This process should be less modified by changes in public opinion, but there has been a clear reduction in the numbers of coronial autopsies as well. This decline in the number of autopsies is likely to be detrimental to clinical practice and research. There is therefore increasing interest in finding potential alternatives or adjuncts to autopsy for patients who die as a result of traumatic brain injury. In this article, the trends in current rates of autopsy will be examined, with a brief review of the change in current laws, the types of autopsy that are practised, the English legal requirements for coronial and hospital autopsies, current research into alternative methods of autopsy and the implications for nursing practice.
The psychosocial impact of communication changes in people with Parkinson's disease
Authors: Whitehead Bridget 
Published: May 2014

Aim: to explore the perspectives of individuals with Parkinson's disease and their spouses on their experiences of living with communication difficulties as a consequence of the disease. Design: Semi-structured interviews were conducted with four individuals with Parkinson's disease and three spouses. A thematic analysis of the content was used to identify themes from the discourse. Results: Themes identified included: (1) individuals' perceived change in self, misperception by others, and coping strategies; and (2) spouses' experiences, including communication changes in partner, the impact on the spouse, other people's reactions, and speech and language therapy. Conclusions: Communication changes occurring as a consequence of Parkinson's disease significantly impact on both the individual's and spouse's psychological and social functioning. This study advocates provision of a broader, social model of service delivery, incorporating elements of counselling, group therapy and social support, in order to meet patients' and families' needs more effectively. Specialist nurses working with this patient group need to be aware of the psycho-social impact of communication difficulties and early referral to speech and language therapy should be considered.
The psychological impact of the unpredictability of multiple sclerosis: a qualitative literature meta-synthesis
Authors: Wilkinson Hannah Rose , Nair Roshan das 
Published: May 2014

Background: Multiple sclerosis (MS) is a neurological condition characterised by an unpredictable nature. This characteristic is reported to be the largest challenge for individuals with the condition. Chronic illness literature highlights the psychological impact of unpredictability, but there is a paucity of research examining this concept in MS. Objectives: This systematic review aimed to explore the psychological impact of unpredictability in MS. Methods: A meta-synthesis was conducted. A total of 6 studies with 59 participants were reviewed and critically appraised. Themes relating to the psychological impact of unpredictability were extracted and synthesised. Results: A preliminary model of the unpredictability of MS was developed highlighting the different psychological impacts of diagnosis, remission and relapse. Conclusions: The psychological impact of unpredictability alters through diagnosis, remission and relapse. Further research is required to explore the experience of unpredictability in MS.
Looking at midwifery over the last 100 years
Authors: Warriner Sian 
Published: May 2014

The centenary of the 1902 Midwives Act this year has given midwives the opportunity to reflect on their profession. The Act was part of a wave of social legislation that typified the late 1880s and early 1990s when reformers had grown increasingly concerned about the conditions under which large sections of the population lived and the social consequences of poverty and ill-health. The Act constituted a radical break from midwifery's past, it provided the legal power to reform the practice of midwifery, which at this time was described by the Institute as unorganised and typically practised by working-class lay midwives. For almost two decades after the passage of the Act, the majority of registered practising midwives continued to be working class women with no formal training. However, as described by Elizabeth Roberts (1984): ‘…many of these midwives could be close as friends with the woman they attended and that when faced with a long and anxious labour nothing could replace the steady nerves and comforting hand of an experienced midwife.’
Webwatch
Authors: McDonnell Cheryl 
Published: May 2014

During 2003 The Nursing and Midwifery Council and DoH have undertaken a number of consultation exercises that are significant to the practice of midwives. Many of the proposed changes could have profound implications for those midwives who choose to practice independently of the NHS and debatably offer women an opportunity for greater choice and continuity in their birth experience. The Independent Midwives Association (IMA) represents the largest body of midwives working independently within Britain and it is their website, or at least the part open to public access, that is the focus of this months review: www.ima-acceptance.org.uk
Step 57: the NHS legislative changes
Authors: Dimond Bridgit 
Published: May 2014

The NHS was set up in July 1948 on the basis of the legal provisions of the NHS Act 1946. Subsequently the main provisions of this Act were re-enacted in the NHS Act 1977. Section 1(1) of the 1977 Act places duties on the Secretary of State to continue the promotion in England and Wales of a comprehensive health service designed to secure improvement in: ▪ The physical and mental health of the people in those countries, and in the ▪ Prevention, diagnosis and treatment of illness and provide and secure the effective provision of services in accordance with this Act.
The Birth Place Choices Project: Phase one
Authors: Barber Toni , Rogers Jane , Marsh Sarah 
Published: May 2014

The Birth Place Choices (BPC) Project was carried out between May 2003 and May 2005 as a collaboration between Southampton University Hospitals NHS Trust and Portsmouth Hospitals NHS Trust. The BPC Project had three aims: 1. To identify factors that influence women's decisions about where to give birth 2. To determine whether the introduction of specially designed information and educational initiatives increase women's knowledge of choices for place of birth 3. To determine whether implementation of these initiatives was associated with an increase in the number of women choosing to give birth outside main consultant-led maternity units. Phase one of the BPC Project, described here, addressed the first aim. This is the first of three articles describing the work of the BPC Project. Following a literature review and an analysis of locally collected routine statistics relating to birthplace, a cross-sectional survey of local women and focus groups involving local women and midwives were carried out. The findings revealed that, compared to other health professionals, midwives had the greatest influence on maternity service users with regard to their birth place choices, yet were perhaps not using their influence effectively to ensure local women were aware of all their birthplace options, including midwifery-led units and home birth.
Teenage mothers' experiences of maternity services: a qualitative study
Authors: Arthur Angela , Unwin Sally , Mitchell Theresa 
Published: May 2014

There is a plethora of literature examining the social, economical and psychological effects of teenage pregnancy, but there is a paucity of evidence that explores teenagers' perceptions of their local services before, during and after their pregnancy. Teenage Pregnancy Liaison Midwives collected data from interviews with teenage mothers between April 2005 and May 2006. These data were subsequently analysed by the midwives between May and October 2006 using a framework proposed by Diekelmann (1990). Eight participants were recruited from statutory and voluntary organizations across a county in south-west England. Accessing clinic venues and opening times were highlighted as major problems. The first six months of a pregnant teenager's confinement appears to be the most unstable, where breakdown in family relationships, housing issues and fear attribute to poor utilization of services. It is useful to identify which agencies teenagers feel are most supportive and how prepared they feel for pregnancy, labour and parenthood.
‘A tale of two cities’: auditing midwifery practice and perineal trauma
Authors: Mutema Eric Kinoti 
Published: May 2014

A lot of interest has been expressed on reduction of morbidity from perineal trauma sustained after childbirth with emphasis on doctors' training. It is of great concern however that similar effort has not been directed toward midwifery colleagues who perform most of the deliveries. This audit was carried out in two district general hospitals (A and B) and aimed to assess the adherence to standards of management of perineal trauma sustained following vaginal delivery. Questionnaires were distributed at random to qualified midwives attending their routine shifts in the respective labour wards. The midwives were asked to complete and return the form during their shift. Only 35% (A) and 30.4% (B) of midwives had had formal training on repair of perineal tears. Less than 65% could correctly identify a first degree perineal tear and the percentages were much less on the more severe tears. Eighteen per cent in A and less than 30% in B performed rectal examinations as recommended. More than 90% of the midwives felt inadequately prepared to assess and/or repair perineal tears in both units and all of the midwives were keen to attend study days on perineal trauma. There was a general lack of knowledge on the agreed classification of perineal trauma, and most midwives involved in the assessment and/or repair of perineal trauma felt inadequately trained in this area. Up to a third of the midwives who participated do not perform rectal examinations on assessment or after repairing the perineal tear, which falls short of Royal College of Obstetrics and Gynaecology (RCOG) standards. It is imperative that the training needs of midwives on this aspect of midwifery care are addressed. It is particularly important because midwives conduct more than half of all deliveries in the UK.
Woman-centred or women-centred care: does it matter?
Authors: Leap Nicky 
Published: May 2014

The concept of woman-centred care is fundamental to midwifery and underpins the philosophy statements of midwifery professional organizations. It has also been used as a framework in a range of policy documents and standards related to midwifery and maternity service provision, notably in the UK and Australia. This discussion article questions the conceptual and practical implications of substituting ‘women-centred care’ for ‘womancentred care’ in terms of addressing women's individual needs and shifting the locus of control away from the institution and professionals towards the woman herself. Contested meanings of woman-centred care and empowerment are explored in relation to conceptual interpretations and the development of projects involving midwifery continuity of care.
Midwives' interactions with women who smoke in pregnancy
Authors: Ebert Lyn Maxine , Freeman Lesa , Fahy Kathleen , Riet Pamela van der 
Published: May 2014

This article presents the findings from a study examining midwives' interactions with women who smoke in pregnancy. The aim of this study was to find out how midwives currently interact with women who smoke in pregnancy, in relation to the women's health and wellbeing. The study used an interpretive interactionism design. There were two major findings: there is incongruity between midwives' internal discourses and expressed discourses when working with women who smoke in pregnancy and smoking cessation advice interactions typically do not involve a dialogue. Smoking cessation advice interactions are predictable, monotonous and non-productive. This type of interaction is best understood as a game with set rules and roles. Midwives need a woman-centred discourse from which to engage in an effective dialogue with women who smoke in pregnancy. Recommendations for practice and education are discussed.
Birthrate Plus: using ratios for maternity workforce planning
Authors: Ball Jean A , Washbrook Marie 
Published: May 2014

This is the second in a series of three articles exploring the staffing needs in the maternity services. Undertaking Birthrate Plus studies in hundreds of maternity units in the UK revealed a number of issues which affect any assessment of midwifery staffing needs in both hospital and community services. Using a simplistic approach of the annual births in a hospital as the sole basis for assessing staffing needs ignores the movement of women between different health trusts. Many hospitals provide care to women from outside their catchment area and this ‘cross border’ flow significantly affects the numbers of community midwives required. The patterns and policies of intrapartum care have a large impact upon hospital staffing needs, and these patterns vary across different services. Stand alone midwife-led units provide care for women in the community as well as for those who give birth within the unit. If required standards of midwifery care are to be maintained then more focused methods of calculating staffing needs must be used. This article will explore these issues and explain how ratios have been produced and which can be used to assess staffing needs based upon local information.
Exploring pregnancy following a pre-term birth or pregnancy loss
Authors: Wood Lorna , Quenby Shiobhan 
Published: May 2014

This is the first of two papers. The first paper outlines the literature review that informed the pilot study; the second describes the qualitative pilot study: stress, immunity and preterm birth pilot study (SIPP). The review examined qualitative research to understand the area of investigation and determine whether this corresponded with the findings of the pilot study. The SIPP study used semi-structured interviews exploring women's answers to a life events questionnaire as part of a larger quantitative prospective observational study, the stress, immunity and preterm birth (SIP) study. The SIP study examined the association between maternal stress, maternal immune response and pregnancy outcome in women with a history of recurrent idiopathic preterm labour. The review evolved into three broad themes: the impact of perinatal loss on a subsequent pregnancy; the preterm labour experience; and disenfranchised grief.
Is it time to blend student learning?
Authors: Moore Susie 
Published: May 2014

Antenatal screening has traditionally been taught to student midwives in the classroom setting using standard lectures. There is little evidence that this approach is supportive of active learning. This article presents a case study of a blended learning approach and evaluates its outcomes. Students worked in groups and developed a presentation and handout for their peers. The activity was evaluated by means of student feedback and the findings were implemented some weeks later when the activity was repeated for a different topic. The findings suggest that group work and presentations promote active learning and are suitable teaching methods for use across the midwifery curriculum. However, when employed as blended learning interventions, the teaching input may be increased unless feedback and assessment are undertaken by peers.
Midwifery education: making sense of the current challenges
Authors: Ball Linda 
Published: May 2014

Higher education institutions and the NHS both face a number of major challenges. This paper provides an overview of some of the key contemporary publications that will have an impact on the UK university system in the coming months, and attempts to clarify their potential and real effect on the future of midwifery education and the ongoing development of midwifery curriculum. There is a very real risk that recent government proposals for future higher education funding in conjunction with their major reconfiguration of the NHS will both fragment and destabilise existing university education systems. Money is tight, and will become tighter, making the task of meeting the demands of midwifery stakeholders, while not compromising on the quality of the midwifery student experience, even harder for educators. Women and their partners deserve a safe transition to parenthood and a positive and life-enhancing experience of UK maternity services—in the coming months midwifery curricula will be judged on their ability to facilitate this.
Are HIV-infected pregnant women at a higher risk of developing depression?
Authors: Crompton Louise 
Published: May 2014

Aim: To determine whether pregnant women with HIV are at a greater risk of developing perinatal depression (PND). Method: a literature review identified relevant evidence surrounding the prevalence of depression in HIV-infected pregnant women. Inclusion and exclusion criteria were applied to 52 articles, of which five quantitative studies were applicable. Findings: social and psychological factors secondary to HIV infection were noted to be the main reason for an increase in the prevalence of PND. conclusion: Women with a complex psychosocial background are at a significantly higher risk of developing PND. suggestions have been made by the author to incorporate the findings into a care Pathway that allows for the routine screening of all women to help highlight those at a greater risk of developing PND. There is a need for further research to support the findings of the literature review as well as to broaden the current research available in high-income countries. This article focuses on the HIV-infected and HIV at-risk pregnant population of the USA. The prevalence of PND in this population is explored and risk factors acknowledged. Trending risk factors for PND in this population include HIV status, psychiatric history, stress and substance use. These findings are incorporated into a draft tool that could be integrated into current practice.
The meaning of caring in the practice of intensive care nursing
Authors: Wilkin Kathleen 
Published: May 2014

Caring is perceived as human behaviour that includes cognitive, affective, psychomotor and administrative skills within which professional caring may be expressed. It is a vital resource within the highly technological area of the intensive care unit (ICU). The terms care and caring are predominantly used to describe the inherent work and value of nursing. Nursing is a nurturing profession and caring is the essential component of its holistic practice, especially with the critically ill patient. The concept of caring in the ICU is central to the social relationship between the nurse, the patient and his/her relatives. Although caring is not unique to nursing, there is substantive, existing and developing knowledge related to caring in nursing.The concept of caring has been extensively explored in the literature. However, there is still little clarity in the understanding, description, relevance or function of caring in nursing.
The use of antiembolic stockings. Part 1: a literature review
Authors: Walker Linda , Lamont Sue 
Published: May 2014

Aim: To determine, through literature review, the current best practice for selecting and using graduated elastic compression stockings (GECS). In particular, literature was sought to clarify which patients should be given GECS, and whether there were any underlying research recommendations as to which length of stocking should be worn. Background: A procurement exercise identified that the clinical areas within the Surgical Services Directorate at each of the three hospital sites were spending significantly different amounts of money on the purchase of GECS and purchasing significantly different numbers per ward. Further analysis revealed that different hospital sites had different preferences for either knee-length or thigh-length stockings. Nurses and medical staff gave conflicting ideas for the correct use and type of stockings, which prompted the authors to access the literature to establish best guidelines. Methods: A literature review was used to develop best practice guidelines for the use of GECS. Results: There is good evidence from the literature demonstrating that the use of GECS in patients undergoing surgery can be effective in the prevention of deep vein thrombosis, used in conjunction with drug therapy, other prophylactic methods, or alone. Conclusions: There is strong evidence for the use of knee-length stockings instead of thigh-length stockings. It is critically important that patients are thoroughly assessed prior to the application of GECS.