bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing communication skills in occupational therapy, and paramedic students
Authors: Twinley Rebecca 
Published: May 2014

Communication is considered to be a core skill for healthcare professionals. The teaching, learning and development of communication skills are discussed with a focus upon occupational therapy and paramedic practitioner students. A mixed methods approach was taken to gather data; questionnaires were administered to evaluate the final year student opinions regarding how they are taught and learn about communication skills, and how well prepared they felt for practice. Programme Lead feedback was gained regarding student opinions and programme handbooks were analysed to further inform the research. The majority of students prioritised listening skills as the most important communication skill required for practice and held the pre-course expectation to be taught communication skills required for practice. Difference in opinion was highlighted regarding how adequately taught and prepared students felt, with a proportion of OT students feeling inadequately taught communication skills. Findings provide a clear indication of student opinions regarding how they are taught, learn about and are prepared for the communication skills required for practice; students value this training and would welcome more to be included in their programmes. The difference in learning experience is attributed to there being no specific module for communication skills on the OT programme.
They think it’s all over-managing post cardiac arrest syndrome
Authors: Page Michael 
Published: May 2014

Return of spontaneous circulation (ROSC) is the first stage in the successful management of the cardiac arrest patient. The care that the patient receives during the immediate post-ROSC period, has a major impact on subsequent survival from out of hospital cardiac arrest (OHCA), particularly in terms of surviving to hospital discharge neurologically intact. For the first time, the 2010 Resuscitation Council (UK) ( Nolan, 2010 ) guidelines incorporates a section specifically relating to the mangement of OHCA. This review will outline the guidance from the Resuscitation Council (UK) and the International Liaison Committee On Resuscitation (ILCOR) on the management of post cardiac arrest syndrome (PCAS) and how this can be practically implemented in the pre-hospital environment. interventions directly applicable to the pre-hospital phase until handover at the emergency department (ED) will be considered. In addition, specific guidance relating to the management of the ROSC patient in the pre-hospital phase of their care will be provided.
Reflex anoxic seizure: an important diagnosis to remember
Authors: Paul Siba Prosad , Zengeya Stanley , Blaikley Sarah , Powell Leanne 
Published: May 2014

Children may present with a sudden collapsing episode, and the paramedic team is often requested to attend such emergencies. It is important that these episodes are correctly categorised as being either epileptic or non-epileptic events. A reflex anoxic seizure (RAS) is one such presentation. RAS is a paroxysmal, spontaneously-reversing, brief episode of asystole triggered by pain, fear or anxiety. RAS occur due to a brief stoppage of the heart caused by overactivity of the vagus nerve. This is usually triggered by an unpleasant stimulus, following which the child may appear pale and lifeless. The diagnosis is usually made by a paediatrician but it is important that the paramedic team are aware of this condition. A child with a diagnosis of RAS may be managed by reassurance from paramedic practitioners if the child is judged to be well after an episode.
Sticking the knife in: Time to review management of tension pneumothorax
Authors: Heavyside Andrew 
Published: May 2014

Outcomes from traumatic cardiac arrest are poor ( Lockey et al. 2006 ; Soar et al, 2010 ). Those who do survive tend to have had a quickly reversible cuase for their arrest ( Vanden Hoek et al, 2010 ). One such mechanism is tension pneumothorax; and in a retrospective database review of London HEMS traumatic arrests six patients regained cardiac output immediately following decompression of a tension pneumothorax ( Lockey et al. 2006 ). Had their tension pneumothoraces not been rapidly decompressed successfully prior to transport to hospital, the continuation of positive pressure ventilation during CPR would likely have further increased intrathoracic pressure. This would render chest compressions ineffective and almost certainly lead to death. There is currently much doubt surrounding the effectiveness of needle decompression for tension pneumothoraces, and needle decompression without release of air certainly does not rule out this important reversible cause of cardiac arrest ( Rojas et al. 1983 ). In order to improve the outcomes for patients in traumatic cardiac arrest in the UK there is an argument for introducing finger thoracostomy to a paramedics skill set as a safe and effective method of both draining and ruling out tension pneumothorax in the limited setting of traumatic cardiac arrest.
Assessing the accuracy of Internet-based patient information for whiplash
Authors: Power Andrew , Nash Adam , McLoughlin Terence 
Published: May 2014

Objective: The aim of this study was to evaluate the quality and reliability of websites which provide information to patients on whiplash injury using an Internet search tool. Methods: On the application of inclusion criteria, 16 relevant websites were found that met the criteria. These were evaluated using the DISCERN tool, which assesses and scores the reliability and quality of consumer information for health problems. The maximum possible score awarded for an excellent website is 80. Results: Of the 16 websites scored by DISCERN, the majority fell below the maximum. The highest score achieved was 63 and the lowest score 30. Conclusions: The results confirm that clinicians should ensure that they direct patients only to high-value validated websites so that they access appropriate and accurate information.
Exploring paramedic patient assessment
Authors: Thompson James 
Published: May 2014

Objective: This study explored the topic of paramedic patient assessment, investigating how they informed clinical decisions, the challenges associated with performing assessments and the perceived effectiveness of current approaches. Methods: Using a Delphi research method, expert participants were independently interviewed which encouraged them to share experiences and views. A thematic analysis approach was then used and the data coded and organised into a series of statements to represent the collective expert views. Statements were then returned to the expert participants for validation and comment. Results: A process of paramedic care delivery was defined, whose activities were largely identified as representing areas of assessment. Protocols and guidelines which are designed to inform paramedic interventions influenced every stage of care delivery. The depth and breadth of a paramedic's patient assessment were found to be limited once indications for a treatment guideline have been satisfied and the main contraindications are excluded. Current formal assessment tools skills being utilised by paramedic staff (including protocols and practice guidelines) were considered only effective for encounters with critically ill patients, and were of limited benefit to the assessment of patients of a lower clinical acuity. There was a direct correlation between the increased paramedic confidence in their patient assessment skills and the more critical the patient's condition. Paramedics were the least familiar or confident with the assessment principles and skills linked with the lower acuity of patient illness. Conclusion: When compared to both national and international ambulance case loads, it is significant that those groups of patient complaints representing the vast majority of ambulance work are the same patient cohorts for whom the paramedic has the least knowledge, preparation and confidence in relation to assessment. Findings relating to the defining of a paramedic's role and process of care distinctly features assessment skills to be both a major component of all pre-hospital activities and integral to the effectiveness of all interventions to follow. This should firmly place
Clinical placements in residential care facilities part 1: positive experiences
Authors: Lucas Peter , McCall Michael , Lea Emma , Eccleston Claire , Stratton Brigit , Crisp Elaine , Andrews Sharon , Robinson Andrew 
Published: May 2014

Objective: This paper analyses aged care clinical placements undertaken by undergraduate paramedic students participating in the Wicking Dementia Research and Education Centre's ‘Teaching Aged Care Facilities Program’. Student views on positive learning experiences during placement are identified in order to support further development of high-quality evidence-based clinical placements. Setting: A cohort of final year undergraduate students (n=17) completed a 5-day clinical placement in two participating residential aged care facilities in Tasmania, Australia. Method: The research involved the collection of qualitative data during weekly student feedback meetings whilst on placement that were recorded and transcribed. Quantitative data from pre- and post-placement questionnaires were collected and analysed using IBM SPSS Statistics 20.0. Results: Positive learning experiences identified by students include: an increased understanding of dementia and dementia palliation; development of ‘soft skills’ such as empathy and communication skills; and improved understanding of the operations of residential aged care facilities. Conclusions: Paramedic practice is an emerging discipline that needs to consider the positive learning experiences identified in this analysis. This will facilitate further development of quality, evidence-based models of undergraduate paramedic student learning in residential aged care.
What makes clinicians decide to use spinal immobilisation? A review of the literature
Authors: Cornah Julia 
Published: May 2014

Current practice of spinal immobilisation appears to be based heavily on historical practice rather than scientific precedence. Evidence shows that it is common practice to immobilise patients, yet studies demonstrating the benefit of this is limited. The decision made by the clinician to immobilise a patient is based on fear of reprisal, caution and ritualised practice rather than robust clinical assessment or a definitive criteria. A global, standardised criteria and robust immobilisation method is yet to be established. This article will examine and critically analyse existing literature surrounding patient immobilisation following a suspected or confirmed acute neck injury. In particular, literature on the use of a cervical collar and head blocks and the use of clinician decision tools will be critically analysed.
An efficacious and competitively priced option for asthma and COPD
Authors: Greener Mark 
Published: May 2014

Asthma and chronic obstructive pulmonary disease (COPD) are among the most common conditions managed in primary care – healthcare professionals currently treat 5.4 million patients for asthma. In 2005, there were 842,100 cases of COPD in England, equivalent to one person in every 59 of the population. Yet despite a growing armamentarium and evidence-based guidelines, management often remains suboptimal. Better management could potentially avoid 75% of hospital admissions and up to 90% of deaths from asthma. Even mild COPD may impair daily activities and undermine health-related quality of life. Choosing the most appropriate inhaler for each patient can help optimise outcomes. Moreover, before increasing the dose or introducing another treatment, healthcare professionals need to exclude, as far as possible, factors that could compromise the treatment response including non-adherence, trigger factors and poor inhaler technique. There is no evidence suggesting the order in which asthma patients should use devices other than metered dose inhalers. Therefore, clinicians should consider cost and patient preference when deciding which inhaler to prescribe. This feature examines the place of the Easyhaler range in COPD and asthma management. This product focus has been supported by an educational grant from Orion Pharma.
Statins: time to treat low-risk patients?
Authors: Greener Mark 
Published: May 2014

In brief ▪ New study says that statins should be offered to low risk patients as well as high-risk patients ▪ Mixing atenolol with apple juice could reduce its efficacy ▪ A proactive approach to medicine management reduces inappropriate prescribing and medication-related problems ▪ Nurses want clearer guidance on when medicines can be administered with food or drink ▪ Taking probiotics can reduce antibiotic-related diarrhoea
Contraception and Safer Sex
Authors: Ellerby Katherine 
Published: May 2014

Teenage sexual health, in the light of the Government's Health of the Nation report (1992) and amendments to the 1993 Education Act, is a cause for concern. This study examines the knowledge of contraception, safer sex practices and family planning services among a group of 16-18 year old sixth form students. The quantitative study used a structured questionnaire adapted for self-completion by a non-probability convenience sample of 250 sixth form pupils. Data were collected during morning tutorials, analysed manually. The overall findings of the study demonstrate a limited knowledge of local family planning services, with poor perception of GP services and confidentiality. A lack of clear knowledge of the methods of contraception in relation to prevention of pregnancy and safer sex was also demonstrated with evidence of risk taking behaviour. The implications of the findings are considered in relation to the need for further research into the sexual behaviour of 16–18 year olds. Also demonstrated was the need to improve the educational and family planning services available.
Letters
Authors: Smith Catherine Gordon , Charlton Rodger , Thomas Monica , Young Lynn 
Published: May 2014

The revisiting venesection article in the November issue has provoked one reader to raise some important questions about this procedure. One of the authors of the venesection article responds with some thought-provoking points of his own. The debate about practice nurses' pay continues. One reader questions the difference between the way doctors and nurses are rewarded for their training and experience. Lynn Young from the RCN responds.
Use of veterinary diets for dogs and cats hospitalized at a veterinary university clinic in Sweden
Authors: Sallander Marie , Jaktlund Annica 
Published: May 2014

Background: Few scientific studies have reported on the use of veterinary diets. Aim: To examine how many of the dogs and cats were given diets suitable for their medical conditions and how they complied with the diet both at the clinic and at home. Methods: Five days recording of dietary intake at a Swedish university animal clinic, and a combined mail and telephone questionnaire to owners 6 months later. Results: The most common type of disease seen in dogs and cats hospitalized at the university clinic at the Swedish University of Agricultural Sciences is gastrointestinal problems (44 and 46% of the dogs and cats, respectively). Dogs have more oncology problems and individuals that have been poisoned, while cats suffer from more urological problems. At the clinic, a total of 56 and 85% of the dogs and cats, respectively, were put on veterinary diets. When discharged 43 and 32% of dogs and cats, respectively, were prescribed a veterinary diet. Most owners (92%) stated that they believed the veterinary diet had positively influenced the health of the animal. Conclusion: Veterinary clinics should put more focus on the fact that the diet plays an mportant role in the recovery of the animal both at the clinic and at home.
How to carry out initial treatment of traumatic wounds: assessment, preparation and lavage
Authors: Aldridge Paul 
Published: May 2014

Traumatic wounds are commonly seen in veterinary practice, and can have a wide range of aetiology and severity. What all traumatic wounds have in common is that they present with the same impediments to healing: bacterial contamination; foreign material; and necrotic tissue. These impediments will be present in varying degrees depending on the aetiology and the time elapsed since injury, but in all cases they need to be addressed in the early stages of wound management. Wound lavage and debridement are commonly performed with the aim of producing a healthy wound bed. This article looks at how wounds can be succesfully managed from presentation through to lavage. The goals are to prevent further contamination from the clinic environment and patient's skin, and then reduce the contamination present in the wound with effective lavage technique.
Improving patient safety in the perioperative period: surgical safety checklists
Authors: Gasson James , Wager Catherine 
Published: May 2014

Surgical complications are an unfortunate part of both medical and veterinary practice, but many are considered to be preventable if appropriate measures are implemented. In human healthcare, one of these measures has been the introduction of surgical safety checklists (SSCs). With proven origins in aviation, another high risk industry, checklists have been linked with the reduction of peri-operative complications and deaths in human hospitals by significant amounts. Recognising that the core values of SSCs are equally applicable to veterinary practice, the Animal Health Trust implemented their use in November 2008. Since then, positive outcomes observed include increased unity among the multiple specialist teams working in the theatre environment and improved communicaiton of vital information regarding individual patients and surgical procedures.
The Effect of Interincisal Opening, Cavity Location and Operator Experience on the Energy Delivered by a Light-Curing Unit to a Simulated Dental Restoration
Authors: Harun Nor Asilah , Santini Ario , Roebuck Elizabeth M 
Published: May 2014

Background Curing of resin-based composites depends on the delivery of adequate total energy, which may be operator dependent. Aim To determine the effect of interincisal opening, cavity location and operator experience on the total energy delivered to simulated cavity preparation sites. Design Three cohorts were included: junior dental nurses, senior dental nurses and qualified dentists (N=5, each cohort). Each operator (participant) followed the same procedure and light-cured two simulated restorations in a MARC® patient simulator using a Demi™ light-curing unit for 20 seconds in each of the following situations: left upper second molar (UL7), interincisal opening at both 25mm and 45mm; upper central incisor (UR1), interincisal opening at 45mm. The light energy delivered by each operator in each situation was recorded. Five readings for each operator were taken at each interincisal distance. Statistical comparisons of delivered energy (J/cm2) between interincisal openings, location and groups in the total energy delivered were performed using the Kruskal-Wallis nonparametric test: α=0.05. Results Less total energy was delivered to the posterior cavity at 25mm (12.0 ± 5.3J/cm2) than at 45mm (16.9 ± 5.6J/cm2) by all operators ( P<0.05). At 45mm, less total energy was delivered to the posterior cavity compared to the anterior cavity (25.1 ± 7.4J/cm2; P<0.05). There was no statistically significant difference between junior nurses and qualified dentists ( P>0.05) but there was a significant difference in the total energy delivered between senior nurses (20.1 ± 7.8J/cm2) and junior nurses (17.5 ± 7.6J/cm2) and between senior nurses and qualified dentists (16.6 ± 8.7J/cm2) ( P<0.05). Conclusions Interincisal mouth opening, location of the cavity and operator experience affected the total energy delivered to cavities in a simulated clinical environment.
Stop motion: From plastic to plasmatic cinema
Authors: Lepot Cyril 
Published: May 2014

Abstract
When talking about Animation as a graphic or a plastic cinema it is underlying a certain idea of what the medium is and how it is different from live-action films. On the one hand it is about creating the movement and on the other hand it deals with an infinite kind of techniques related to fine arts and graphic arts to produce the images needed, in a word: the forms. Among these techniques, the Stop motion as a privileged medium based on frame-by-frame, shows that reality and its matter can be animated too and not only the abstract space of the representation, be it a drawing or 3D modelling. With Stop motion, even if the technique can be ‘reduced’ to animating puppets and a set or clay for example, we will argue that its specificity lies more specifically in the possibility of changing the propriety of a matter and its limit of elasticity to the point of breaking the consistency of things, transmuting the substance into another. In this state of thing, the link between creating form and creating movement cannot even be drawn anymore because the form and movement are one and the same consequence of the substance behaviour the artist is giving to matter, whereas in traditional animation you create a form more or less stable and you make it move. This art, now interrogating the global notion of arts of movement, cease to be a graphic or plastic cinema and becomes what we would call a plasmatic cinema. The form never really gets a permanent consistency and integrity to be able to be seen as a moving object or subject but as pure protoplasm constantly transforming and redefining a matter. Indeed, the natural limit of elasticity of matter can be modified with Stop motion to the point that anything can become subject to plasticity – not only a gum in cinema or the body of a drawn character in animation, for example. In these kinds of cinema the matter is pure virtuality, where in Stop motion it is real matter becoming virtual through the plasmatic process: movement is just a change of the form and form just a change of character through movement. The whole matter of the world is becoming a material to be liquefied and redefined where movement and forms are sharing the same state of the art. If a plasma is in chemical research the fourth state of matter (with solid, liquid and gas) we would say by analogy that it also helps to define another kind of animated picture dealing with a perpetual fusion (or fusing) of forms. In that sense, Stop motion is exemplifying what is plasticity of motion, in the overall arts of motion.
Aesthetic affordances: Computer animation and Wayang Kulit puppet theatre
Authors: Jernigan Daniel K. , Chansavang Anthony , Martin-Rall Hannes , Hock-Soon Seah , Lim Darren , Johan Henry 
Published: May 2014

Abstract
This article describes the various animation techniques we used in creating our short animated piece,
Si Lunchai (based on the Indonesian folktale of the same name). We took our aesthetic inspiration from Indonesian Shadow Puppetry (Wayang Kulit). Because 3D animation technology provides many ‘naturalistic’ advantages not available in traditional shadow puppet performances, much of the challenge of the work involved seeking out compelling compromises between retaining the aesthetic value of the original Wayang Kulit, while also taking advantage of the various affordances of 3D animation. Among other things, this essay describes working with 2D characters in a layered (2.5-D) environment, character mobility and pivot points, character ‘flipping’ and our attempt to maintain some sense of the live action quality of Wayang Kulit theatre.