bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of 3D photography in complex-wound assessment
Authors: Savage J.M. , Jeffery S.L.A. 
Published: May 2014

Objective: To review the evidence to support three-dimensional (3D) photographic imaging in wound care and undertake a feasibility evaluation of one device in the clinical environment. Method: A literature review was undertaken of the role of stereophotogrammetry in wound care. Subsequently, a 3D imaging and data storage system was selected and evaluated in two representative case studies within the clinical environment of the Royal Centre for Defence Medicine. Results: The review suggested that 3D imaging has the potential to provide more accurate data on which to base treatment decisions. In practice, the device was found to be relatively easy to operate and sufficiently robust to handle the demands of clinical practice. However, the high initial cost of the unit and the time taken to download images to the database meant that its benefits were limited to more complex wound types. Conclusion: Three-dimensional photography has the potential to play a role in management options; however, current technical issues limit its potential and the incorporation of a highly defined image (similar to that of a standard digital 2D photograph) within its 3D representation would make it more powerful. Declaration of interest: Access to the digital imaging device and user software was provided by Eykona Medical Ltd. The company had no influence over the evaluation process or the content of this paper. The authors have no additional conflicts of interest to declare.
The gum elastic bougie: One of anaesthesia's best-kept secrets
Authors: Hinds John D , Michalek Pavel 
Published: May 2014

Recent guidelines for paramedic intubation have been published by the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) (2008). One important recommendation for paramedic intubation is that: ‘When prehospital tracheal intubation is undertaken, a gum elastic bougie should be available routinely’. Despite this, the bougie has not been universally available among ambulance services in the UK—up to a third do not include the bougie as part of their airway management strategy. We aim to introduce the bougie, provide information on its use, advantages and pitfalls, and provide some tips as to how to get the most out of this invaluable device in clinical practice.
From trade to profession-the professionalisation of the paramedic workforce
Authors: First Sue , Tomlins Lucy , Swinburn Andy 
Published: May 2014

How do we achieve professionalisation of the paramedic? The Trait theory identifies profession as having 1. An exclusive body of knowledge 2. Self regulation and 3. Registration. Becoming a profession leads to improved remuneration and greater respect and knowledge, but this does not lead to a change in personal conduct. Professionalism however, is connected to behaviour, attitudes, accountability and responsibility. The behavioural changes and attitudes required of a ‘professional’ are brought about through the combination of higher education and clinical leadership. Academic input integrates clinical leadership with the career structure and all staff at all levels. Clinical leaders are at the coal face, accessible during and after the event, for training and clinical supervision and are therefore transforming practice at every level.However, clinical leadership is ineffective with an uneducated workforce and an uneducated workforce is ineffective without clinical leadership, thetwo go hand in hand So... What is the way forward for the ambulance service? What are paramedics doing to develop and maintain the profession and professional
First evaluation of CPD advanced paramedic teaching methods in Ireland
Authors: Knox Shane , Cullen Walter , Collins Niamh , Dunne Colum 
Published: May 2014

Aim: Continuing professional development (CPD) will soon be mandatory for advanced paramedics (APs) registered with Ireland’s pre-hospital regulatory body. Effective and efficient CPD methodologies are needed. We determined what type of training methods might be used to reduce associated costs while maintaining effectiveness and benefit. Methods: In 2010, an ‘up-skill’ programme for APs was introduced in Ireland comprising: a) self-directed learning using a purpose-designed manual; b) workbooks based on the manual and clinical practice guidelines; c) small group practical sessions with discussion-based skill stations; and c) practical scenario-based assessment. Participants were invited to complete a web-based survey assessing a) short-term effectiveness, b) medium-term effectiveness, and c) user friendliness of the educational modalities. The preferred learning styles and respondents’ perceptions of outcome were determined. Results: Overall 49 % of participants responded. Of those eligible, 73 % believed that practical learning encouraged knowledge retention and skills in the immediate and medium-term, 82 % believed practical learning influenced patient care immediately, while 75 % stated that it influenced patient care six months later. All respondents agreed that practical learning was important, with 90 % stating that it was enjoyable. Overall, 80 % found the provided manual accessible, while >40 % believed that the manual alone did not provide all necessary information, 77 % had referenced it since completing the programme. Conclusion: APs enjoyed, and benefited from, the educational programme and the knowledge gained benefited patients in the short and medium-term. This study suggests that educators and training sponsors should consider the benefits of small group-based practical learning for APs.
Exploring the developmental need for a paramedic pathway to mental health
Authors: Elliott Ruth , Brown Paul 
Published: May 2014

The following article discusses an organisational development need of a national ‘Mental Health Pathway’ to enable paramedics to provide the appropriate care for people who present mental health issues. The Department of Health acknowledges the huge modernisation of the ambulance service in England and faster access to people with immediate life-threatening conditions; however, the service is also responding to an increasing number of patients who have an urgent primary care need, which includes mental distress, as opposed to clinical emergency. The Department of Health (2009) policy calls for a ‘new vision’, where the ambulance service could increase efficiency and effectiveness towards patients who are experiencing non life-threatening emergencies. The key aims are to form a programme of advancement to address both improving mental health and accessibility of services for people with poor mental health. The vision of the policy is that by 2020 mental and physical health will have equal priority. The development of a mental health pathway within the ambulance service may help to reduce admissions or re-attendance, while improving care for patients. An evidence-based approach is used to provide a balanced, logical and supported argument within a reflection of practice. This is evaluated against a hypothetical patient’s case study, which reflects common issues faced by paramedics and ambulance technicians. The analytical process considers patient, professional, organisational and multi-disciplinary team perspectives.
Prescribing in osteoporosis
Authors: Munson Eileen 
Published: May 2014

Osteoporosis is a silent chronic disease that is not a visible condition, as it is only diagnosed once a fracture has occurred. It affects all age groups, but is most prevalent after the age of 50 years old, when it affects 1:2 women and 1:5 men during their remaining life time. This has a huge impact on the cost to the nation. Low bone density is the major risk factor for having a fracture. But several other clinical risk factors can be identified. The role of the nurse prescriber is to predict and prevent a fracture occurring, by initiating cost effective recommended therapies. The National Institute for Health and Clinical Excellence (NICE) has recently evaluated the therapies for secondary prevention of osteoporosis. How long a therapy should be continued for remains unavailable but re-evaluation of risk factors and need for therapy after 5 years is advised.
The role of adalimumab in treating Crohn's disease
Authors: Younge Lisa 
Published: May 2014

Crohn's disease is a chronic inflammatory bowel disease. It typically presents with symptoms including abdominal pain, bloody diarrhoea, fistulae and stricturing of the bowel, resulting in obstruction. There is no medical cure for the condition; current medical approaches are concerned with symptom reduction and promotion of quality of life. These outcomes can be difficult to achieve, and involve invasive treatments, often with undesirable side-effects for the patient. Traditionally, Crohn's disease has been managed with anti-inflammatory drugs including steroids and aminosalicylates, with the more refractory cases requiring the introduction of immunomodulating drugs such as azathioprine. Despite these approaches, a significant number of patients will continue to experience ongoing and troublesome symptoms, severely impacting on their quality of life, and often resulting in surgery. Adalimumab (Humira) was the second biological agent to be licensed for the treatment of Crohn's disease in late 2007. Similar to infliximab, it is a monoclonal antibody which binds to anti-tumour necrosis factor α (anti-TNFα). This article will outline the clinical use of adalimumab, and discuss its current place in the therapeutic pathway of patients with Crohn's disease.
Researching the barriers to mental health nurse prescribing
Authors: Ross Jane 
Published: May 2014

Although nurse prescribing has been established in many countries for a number of years, the same cannot be said for mental health nurse prescribing. Although there is evidence of ‘pockets’ of practice throughout Scotland, it appears to be the exception rather than the rule. Why is this the case? Because mental health nurse prescribing has been so slow on the uptake, this prompted the question ‘What are the barriers to implementing mental health nurse independent prescribing in Scotland?’ This article illustrates the importance of the research question. It concludes that in order for nurse independent prescribing to progress that it is essential that barriers are identified.
Readers' Letters
Authors: Beech John 
Published: May 2014

In support of all care assistants Madam, I would like to write a few words in support of all care assistants and have written a poem to that effect. NVQs, national minimum standards and the Agenda for Change initiative do go some way to recognizing a care assistant's role and responsibilities, touched upon by Jackie Pritchard's article (vol.6(7), 2004, p.316).
Facial swelling
Authors: Watkins Jean 
Published: May 2014

Since the introduction of the measles, mumps and rubella (MMR) vaccine in 1988, the incidence of mumps in young children has dropped dramatically. Notific-ation of the disease in the UK became obligatory in the same year, and since then the num-bers numbers reported have remained at only about 2000 a year. Between the years 2003–5 numbers increased to about 8000, mainly in young people over the age of 15 years, probably because this age group were too old to receive MMR when it was first introduced. As a result, this age group missed immunization, or received one dose only, and so lacked adequate protection from mumps (Department of Health (DH), 2005). Mumps is still, therefore, only too likely to appear in surgeries making it important to be able to recognize the condition and be aware of other diagnoses that might mimic it (Table 1).
An evaluation of patient participation groups for people
Authors: Pick Alison 
Published: May 2014

The aim of this study was to evaluate the work of four diabetes patient participation groups in Southwark Primary Care Trust to inform the group leaders in their efforts to develop and improve the groups' operation and support of patients. Method: A questionnaire was distributed to 661 patients on the local PPGs' mailing list and 234 were returned, a response rate of 38%. Separate ‘illuminating’ interviews were conducted with three participants who attended less regularly. Results: Key findings were that: (1) the diabetes PPGs helped provide people with more knowledge, information and skills to manage their diabetes with greater confidence; (2) about 45% of patients (n=106) said that the groups had helped them manage medication better; (3) 57% (n=134) reported that the groups had helped them change their diet and 65% (n=152) of patients said that the groups had helped them to learn to eat more healthily. Conclusions: It is recommended that access to meetings is improved for patients with time and mobility constraints, and that PPG funding is made more secure.
Unintentional hypothermia: implications and management of the post-operative patient
Authors: Bowers Lynne 
Published: May 2014

Inadvertent hypothermia is not uncommon in the immediate post-operative period and is associated with impairment and abnormalities in various organs and systems that can lead to adverse outcomes. While there is much research to support the negative effects of hypothermia, often the focus is aimed towards minimizing heat loss in the peri and intra-operative period, however patients continue to lose heat post operatively, which can contribute to both short and long-term problems. Veterinary nurses have a pivotal role to play in minimizing such losses, with the main objectives consisting of detecting and recording post-operative hypothermia, as well as minimizing further heat loss and correcting any temperature deficits. Simple nursing interventions including careful positioning of post-operative patients away from draughty areas of the ward, frequent monitoring and recording of body temperature, and a combination of passive and active rewarming techniques can prove extremely beneficial to the recovery of hypothermic patients in the postoperative period. Using the recommendations highlighted within this article it may be possible to minimize the physiological effects of hypothermia as well as to improve patient comfort during this important recovery phase.
Nursing care of the burns patient
Authors: O’Dwyer Louise 
Published: May 2014

Nursing patients with burn injuries can be hugely challenging as the individual may have severe metabolic, cardiovascular and pulmonary derangements, not to mention large tissue deficits. A range of systems have been developed to classify burn wounds including percentage of body surface involved, through to depth of tissue involved and the use of these systems may help in giving a prognosis of the extent of the injury. The treatment of burn wounds can start at home by the owner and appropriate early therapy can make a huge difference to the extent of the injury. All major body systems may be affected due to the nature of the injury and so early fluid therapy, analgesia, respiratory derangements, including carbon monoxide toxicity, wound management and analgesia need to be addressed appropriately. The close monitoring of these patients is vital in order to achieve a good outcome and so these cases rely heavily on good nursing care and attention to detail, so a good background knowledge of these considerations is essential.
How to blood type and cross-match
Authors: Barnett Wendy 
Published: May 2014

In the UK blood components (products), packed red blood cells, fresh frozen plasma, frozen plasma, cryo-precipitate and cryo-supernatant have only been available since the emergence of blood banks 5 years ago. This has led to advancement in transfusion medicine and a positive outcome for thousands of patients whose previous treatment options were restricted due to the lack of available blood. To date in the UK only canine blood products are available with feline transfusion patients being restricted to the option of fresh whole blood donated from emergency donors at the time. With blood products now more widely available a greater understanding of using them becomes ever more important not only to ensure transfusions are being carried out safely but also to make best use of the blood donated by donors volunteered by their owners. Blood typing and cross-matching are two screening tests recommended to be performed prior to canine and feline transfusions.
Transcending the surface: The animated line between Benjamin, Eisenstein and early animation
Authors: Serrazina Pedro 
Published: May 2014

Abstract
Relating two essays by Benjamin (‘Painting and the graphic arts’ and ‘On painting, or sign and mark’, both from 1917) with Eisenstein’s ‘The dynamic square’ (1930), this article proposes that the drawn line of early animation transcended the surface to challenge established modes of perception at a time of important social and cultural changes.
Benjamin addressed the ‘sphere of the sign’, specifically the meaning of the line within it, and established the difference between horizontal and vertical display (graphic and art work), highlighting the accomplishment of the work of art’s ‘inner meaning’. Eisenstein’s text, presented when the cinema industry was debating the introduction of the wide-screen, questioned the screen and frame proportions.
Relating Benjamin’s ‘magical properties of the line’, Eisenstein’s questioning of the frame and animated film references, this article will trace an approach to the essence of the line as a metaphysical element of transcendence and ‘deterritorialization’ (Klein 1993), suggesting that, in the process that takes the drawing from paper to screen, the lines accomplish their ‘meaning’; and become a projection of an ideal of liberation of body and frame, challenging its limits.
Epithelial regeneration and cancer: news from the Src front
Authors: Sousa‐Victor Pedro , Jasper Heinrich 
Published: May 2014

Src family kinases (SFKs) have long been implicated in tumorigenesis, but the exact requirement for individual kinase members, and their specific spatially and temporally defined roles in the maintenance of epithelial homeostasis remained unclear. A study by Cordero et al () now combines the strengths of Drosophila and mouse models for intestinal epithelial regeneration to characterize the role of individual SFKs in epithelial stem cells, tissue regeneration, and tumorigenesis.
Water retention of the loess-derived Luvisols with lamellic illuvial horizon in the Trzebnica Hills (SW Poland)
Authors: Glina Bartłomiej , Waroszewski Jarosław , Kabała Cezary 
Published: May 2014

Abstract
The aim of work was to characterize the water retention in the silt-textured Luvisols with lamellic illuvial horizon (argic) that occur in the loess covered northern part of the Silesian Lowland. Soil pits were localized on the Trzebnica Hills near the villages: Machnice (profile 1), Skarszyn (profile 2) and Zaprężyn (profile 3 and 4). Profiles Machnice 1 and Skarszyn 2 were situated in the upper parts of the hills covered with beech stands with an admixture of oak, linden and maple. Profiles Zaprężyn 3 and 4 were situated in the central and lower parts of the arable slope. During the field work conducted in April 2011, 29 soil samples were collected for texture, bulk density and water properties analysis. The soils under study were characterized by texture of silt loam with lower clay content in humus horizons (.loamy silt. according to Polish classification), and higher clay content (.clayey silt.) in the illuvial and subsoil horizons. The texture of all examined profiles was dominated by the „loess“ fractions. Variable abundance of the massive lamellae causes variations in water properties of the illuvial (sub-)horizons. It was found that lamellic illuvial horizons in the loess-derived Luvisols have higher field water capacity than the homogenous illuvial horizons, apart of the clay content. There was no apparent effect of the horizon kind (homogeneous versus lamellic) on the soil bulk density. These properties mainly depended on the total clay content in a particular horizon (sub-horizon).
Quality of Life and Self-Reported Lower Extremity Function in Adults With HIV-Related Distal Sensory Polyneuropathy
Authors: Galantino Mary Lou A. , Kietrys David M. , Parrott James Scott , Stevens Maureen E. , Stevens Anne Marie , Condoluci David V. 
Published: May 2014

Background
Distal sensory polyneuropathy (DSP) is a common complication of HIV disease. Its effects on quality of life (QOL) and function have not been well described.

Objective
The study objectives were: (1) to compare QOL and lower extremity function in people with HIV-related DSP and people with HIV disease who do not have DSP, (2) to determine the extent to which function predicts QOL, (3) to evaluate the agreement of 2 function scales, and (4) to describe the use of pain management resources.

Design
This was a cross-sectional survey study with predictive modeling and measurement tool concordant validation.

Methods
A demographic questionnaire, the Medical Outcomes Study HIV Health Survey, the Lower Extremity Functional Scale (LEFS), the Lower Limb Functional Index (LLFI), and a review of medical records were used. General linear modeling was used to assess group differences in QOL and the relationship between function and QOL. Bland-Altman procedures were used to assess the agreement of the LEFS and the LLFI.

Results
Usable data for analyses were available for 82 of the 94 participants enrolled. The 67% of participants who reported DSP symptoms tended to be older, had HIV disease longer, and were more likely to receive disability benefits. Participants without DSP had better LLFI, LEFS, and physical health summary scores. In multivariate models, lower limb function predicted physical and mental health summary scores. The LLFI identified participants with a lower level of function more often than the LEFS. Participants with DSP were more likely to use medical treatment, physical therapy, and complementary or alternative treatments.

Limitations
A sample of convenience was used; the sample size resulted in a low power for the mental health summary score of the Medical Outcomes Study HIV Health Survey.

Conclusions
Quality of life and function were more impaired in participants with HIV disease and DSP. The LLFI was more likely to capture limitations in function than the LEFS. Participants with DSP reported more frequent use of pain management resources.