bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ERICA eye gaze system versus manual letter board to aid communication in ALS/MND
Authors: Harris Donna , Goren Mark 
Published: May 2014

Communication is essential to providing individuals with effective health care, but degenerative neurological conditions such as amyotrophic lateral sclerosis or motor neurone disease (ALS/MND) impair patients' physical ability to communicate to get their needs met. New technologies are giving people with motor disabilities alternative means of communicating with caregivers and health professionals. Aim: The aim of this study was to determine whether ERICA, a hands-free, eye-tracking communication device, is practical for use by people with ALS/MND. The ERICA eye gaze system was compared with a manual letter board and evaluated for speed and ease of use. Method: Six patients were asked to spell out a simple sentence with the assistance of a caregiver, first using a manual letter board, then using the ERICA eye gaze system. Results: Four out of the six patients communicated more quickly using the manual letter board but four out of the six patients rated the ERICA eye gaze system as less difficult to use. Conclusions: It is recommended that health professionals use both low-tech and high-tech solutions to address the loss of speech experienced by people with ALS/MND during disease progression.
Exploring the lived experience of palliative care for people with MS, 3: Views of group support
Authors: Embrey Nikki 
Published: May 2014

This is the third article in a series exploring patients' experiences of palliative day-care services for people with long-term conditions such as multiple sclerosis. In the first article, a literature review of palliative care services for non-cancer patients supported an argument for palliative care services being rolled out for neurological conditions across the UK (Embrey, 2008). Subsequent articles in this series report the findings of three themes to emerge from interviews with nine patients at a palliative day-care service for MS in North Staffordshire. A ‘grand-tour’ approach was adopted for the interviews and the data were analysed using a phenomenological approach. The second article (Embrey, 2009) examined patients' views of therapeutic interventions encountered at the day-care service and indicated the holistic benefits of palliative day-care therapies on physical, psychological and social aspects of life with MS. In this article, patients' views on the benefits of group support from the palliative day-care service are described. The final article will discuss the relevance of information networking in MS care. Further research is recommended to evaluate the effect of hospice-based palliative day-care programmes, with a view to improving MS services at the palliative care end of the disease spectrum, and to identify changes in current clinical practice which will benefit patients with advanced disease.
Nurses' perspectives on their specialist stroke roles in London
Authors: Brooke Joanne , Walia Surinder 
Published: May 2014

Aim: This paper is a report of a study exploring nurses' perspectives on their developing roles in specialist stroke care in London. Method: Nine paired semi-structured interviews with nurses working across the stroke care pathway in London were completed in 2011, recorded and transcribed verbatim. The data was analysed using interpretative phenomenological analysis. Results: The emergent themes included receiving support from fellow nurses, good communication but minimal involvement with the multidisciplinary team, unclear career pathways, and a positive ethos among the nurses. The nurses' responses indicated that they remain passionate and caring. They expressed interest in being more closely involved with the decision-making process within the multidisciplinary team. Conclusion: An understanding of the complex nursing roles within the new London stroke care pathway has emerged. Clear pathways of progression from band 5 to band 6 are being developed.
Female genital mutilation: a midwifes experience
Authors: Parkin Julie 
Published: May 2014

This article is based upon the reflections that were made by the author after providing care for the first time, to an infibulated woman and the general issues raised by the knowledge gained. Female genital mutilation, circumcision and infibulation are the terms used for a range of procedures which involve the partial or total removal of the female external genitalia and/or injury to the female genitals, for cultural or other non-therapeutic uses. The learning outcomes of the reflection, issues of professional accountability and advocacy are discussed. The reasons why female genital mutilation continues to be practised are examined, including women's role in society and the physical and psychological effects of infibulation upon them. The author analyses the legal, ethical and cultural issues that surround female genital mutilation and examines the changes that may be necessary to prevent its occurrence. The midwife's role with regard to sexuality and the care of the infibulated woman are also discussed.
Clinical simulation: a new approach to midwifery education
Authors: Dow Angela 
Published: May 2014

A review of the literature demonstrated that the theory–practice gap caused by a shift from the traditional apprenticeship-style education to higher education institutions (HEIs) ten years' ago might have impacted on the students' fitness to practice at the point of registration. However a new approach to midwifery education, clinical simulation, could transform teaching and learning strategy for undergraduate student midwives. Clinical simulation is based on the concept of experiential learning and can enhance skill acquisition by providing a safe and controlled, student-focused learning environment in a setting that is comparable to reality. While this may offer students the opportunity to apply their learning more easily when they return to the clinical area, further research into the effectiveness of clinical simulation in preparing students for the reality of clinical practice and, in particular, the transfer of simulated skills to the workplace, is suggested.
Obedience and conformity in clinical practice
Authors: Martin Caroline J Hollins , Bull Peter 
Published: May 2014

This study analyzes the psychological processes involved when a midwife accepts directions from a senior person. A representative sample of 20 midwives were recruited from 7 maternity units in North Yorkshire. An inductive thematic analysis was used to interpret interview data. Results showed that midwives respond to social influence from senior people using two processes: obedience and/or conformity. Thirteen (65%) excerpts informed that participants' interpreted direction from the senior person as instructions they were expected to follow (obedience) and seven (35%) showed that others voluntarily changed their viewpoint to agree with the one offered by the senior person (conformity). Participants' behaviour has been explained in terms of ‘legitimacy', ‘perceived obligation to the organization' and ‘social identification'. These pressures create conflict between the midwives' knowledge of how they would prefer to behave and concern to please authority or fit into the social group. Consequently, it may be difficult for midwives to support safe requests from women that conflict with what a senior person
Exploring the perceptions of midwifery staff about safety culture
Authors: Currie Lynne , Richens Yana 
Published: May 2014

This study aimed to describe midwifery staffs' perceptions about safety culture and make recommendations for a positive safety culture that could benefit clients, staff and the organization. This work is part of a wider study exploring the perceptions of both nurses and midwives about safety culture. Data were collected through the use of focus groups and were analyzed using a thematic approach. The study was set in a large obstetric hospital with a diverse client population within an urban acute NHS trust in England. A voluntary sample of 5 senior midwifery managers, 6 community midwives, 17 midwifery students and 5 midwifery support staff participated in the study. Seven main themes were identified from the data: error reporting and under-reporting; client expectations of the service; feedback and learning; decision-making and staffing; communication; prioritization of safety; and staff safety. Key considerations and implications for practice were that: organizations must ensure that all staff are given the authority to complete incident reports; systematic feedback geared towards effective learning is cascaded to all levels of staff; targeted education and training on effective communication strategies and core skills for safety are offered to midwifery managers; foresight training is provided to all front-line clinical staff to make them more ‘risk aware’ and ‘error wise’; and patient safety is accorded the highest priority at trust board level.
Informing choices: outcomes for women at a stand-alone birth centre
Authors: Rogers Cathy , Pickersgill Judy , Palmer Joe , Broadbent Mark 
Published: May 2014

The objective was to determine outcomes for women booked at a stand-alone birth centre (SABC) between March 2000 and April 2008. The design used was a descriptive prospective cohort study of all women who booked to give birth at a SABC from 2000 to 2008. All women who intended to deliver at the birth centre during the study period were approached. The main outcome measures were antenatal, intrapartum and postpartum transfer rates and reasons for consultant-led care, mode of delivery and perinatal outcome. Information was available for 5099 women who intended to deliver. Of this group, 29.9% of women were transferred in the antenatal period, 13.96% were transferred in labour and 5.09% transferred in the postnatal period. During the study period 3573 women were admitted to the Edgware Birth Centre (EBC) in labour and 2861 (80.07%) delivered at the EBC. The overall intrapartum transfer rate was 20%. Transfer rate was eight times higher in the primigravida cohort (35.9% vs 4.61%). Approximately 6% of women were transferred in the postnatal period and 3% of neonates were transferred. Information on modes of delivery was available for 3476 women for women who were admitted to the EBC in labour. Of this group 89.35% had a spontaneous vertex delivery, 5.60% had an emergency caesarean section and 5.03% had an instrumental delivery. The perinatal mortality rate for women admitted to the EBC in labour was 1.1 per 1000 total births. The study concludes that approximately half of all women deemed at low risk of obstetric/medical complications require transfer to consultant obstetric services at some stage during their maternity episode. Intrapartum transfer rate for primagravid women is significantly higher than for multigravid. Overall 95% of women who were admitted to the EBC achieved a vaginal birth.
Implementation and evaluation of a nutritional screening tool
Authors: Langstroth Caroline , Wright Claire , Parkington Tracey 
Published: May 2014

The aim of this study was to implement and evaluate the use of a nutritional screening tool for pregnant women. The nutritional screening tool was piloted by seven midwives on between four and ten pregnant women to assess the tool's ease of use. On completion of the pilot the midwives completed a questionnaire about the use of the nutritional screening tool. The midwives were randomly selected and worked for an East Lancashire hospital. The main study evaluated the diets of pregnant women. A random sample of 55 pregnant women was screened using the nutritional screening tool and their diets assessed using a validated food frequency questionnaire. The participants were recruited at the antenatal clinic. Dietary analysis was performed on the food frequency questionnaire data using Qbuilider. The response from the pilot of the nutritional screening tool by the midwives was positive. The midwives rated the tool easy to use with a clear and simple format. The nutritional screening tool was not statistically validated but the tool had 100% sensitivity and 66% specificity.
Achieving ‘baby friendly’ standards in pre-registration education
Authors: Long Louise 
Published: May 2014

The Florence Nightingale School of Nursing and Midwifery at King's College, London is delighted to have achieved re-accreditation for both of its pre-registration midwifery education courses (BSc 18 months; BSc 3 year). It originally gained accreditation in June 2007. Since then there has been a lot of interest in gaining the award and universities all over the UK are seeking to follow suit. This article will explain what the ‘Baby Friendly’ Initiative (BFI) Educational Standards are; how they fit with the Nursing and Midwifery Council (NMC) essential skills clusters; detail how we placed these standards into our curriculum; the assessment process and what it has meant for our newly-qualified midwives.
Patient satisfaction with provision of information on labour analgesia
Authors: Kamarzaman Zaiti , Clark Felicity , Haque Shamimul , Ghani Afshan 
Published: May 2014

Background:Patient satisfaction assessment is a tool in analysing standards of care. This survey is conducted to audit the standards of labour analgesia care of mothers in Mid-Staffordshire NHS Foundation Trust. The purpose of the audit is to assess women's awareness and overall experience of labour analgesia during labour.Method:A standardized questionnaire survey was performed to ascertain labour analgesia knowledge and satisfaction achieved with analgesia during labour. A further study with the community midwifery team responsible for the antenatal care of mothers was conducted through a semi-structured interview to ascertain labour analgesia information discussed with their patients.Results:The study recruited 333 patients. More than 90% of the patients were satisfied with the labour analgesia information and the usage of analgesia in labour. Community midwives were quoted as the main source of information.Conclusion:Almost all the participants were satisfied with the labour analgesia information and analgesia received during labour within the Mid-Staffordshire NHS Foundation Trust.
Complementary and alternative medicine in the maternity setting
Authors: Jones Catriona 
Published: May 2014

The increasing demand for complementary and alternative medicines (CAM) among childbearing women has been alluded to in midwifery literature for a number of years. There is a wealth of anecdotal evidence suggesting that pregnant women are driving the demand for CAM integration in midwifery practice. Midwives reportedly support the integration of CAM because it promotes normal birth, reduces medical intervention, and results in increased job satisfaction ( Mitchell and Williams, 2007 ). Furthermore, midwifery aided by CAM is considered to be a strategy adopted by midwives to facilitate the process of placing control away from the medical practitioner, and more into the hands of women ( Adams, 2006 ). A literature review was undertaken to gain an understanding of the patterns of CAM demand in the UK. In particular, evidence of the extent of consumer demand for CAM was investigated. This paper presents the findings from a review initially undertaken to explore claims that CAM integration into midwifery is consumer driven. The concept of consumer demand and how this is captured and illustrated across empirical and non-empirical literature is examined. The findings highlight that appropriate research into consumer demand is required to sustain the integration of CAM in mainstream maternity care.
The effect of lavender aromatherapy on pain perception and intrapartum outcome in primiparous women
Authors: Kaviani Maasumeh , Azima Sara , Alavi Narges , Tabaei Mohammad Hossein 
Published: May 2014

Introduction: Labour pain is a main preoccupation of pregnant women. In this study, the authors determined the effect of lavender aromatherapy on pain intensity perception and intrapartum outcome in primiparous women. Methods: In this randomised controlled trial, 160 participants were divided into two groups. The aroma group received 0.1 ml of lavender essential oil mixed with 1 ml of distilled water via tissues attached to their gowns close to their nostrils. Meanwhile, the control group received 2 ml of distilled water in a similar way. Pain intensity perception was measured by Visual Analogue Scale (VAS) before the intervention and at 30 and 60 minutes afterwards. Results: The mean of pain intensity perception in the aroma group was lower than that of the control group at 30 and 60 minutes after the intervention (p←0.001). Conclusion: This study revealed that aromatherapy decreased the labour pain, but did not affect the duration of labour phases and Apgar score.
Adult-trained perioperative nurses' practice of family-centered care
Authors: Hamilton Grainne , Corlett Jo , Dowling Maura 
Published: May 2014

Aim The aim of this study was to explore adult-trained perioperative nurses' practice of family-centered care (FCC). Method A qualitative research design with a hermeneutic phenomenological approach was used. In-depth interviews were conducted with six adult-trained perioperative nurses. Data analysis was guided by Colaizzi's seven-step framework, resulting in a composite description of perioperative nurses' practice of FCC. Findings While participants supported the principle of family involvement in care, they found its implementation in practice difficult and stressful. They reported that families often appeared inadequately prepared for the surgical experience, and subsequent poor experiences for families caused feelings of upset and inadequacy for nurses. Conclusion While some of these findings are similar to those in previous studies of paediatric nurses' practice of FCC, this is the first known study to examine adult-trained perioperative nurses' practice of FCC. Participants articulated an awareness of what constitutes effective FCC and showed the motivation to accomplish the task of improving family-centered practice in their practice area.
Effective partnership working between school nurses and health visitors in safeguarding
Authors: Obadina Seye 
Published: May 2014

Safeguarding is an important part of the work carried out by both health visitors and school nurses. To ensure that children and families’ needs are met, it is essential that both professions are able to work together effectively. This article looks at the main characteristics of the school nursing and health visiting roles in safeguarding with the aim of helping increase the understanding of each other's roles, as well as ways in which they can work together effectively.
Can massage induce relaxation? A review of the evidence
Authors: Smith Toby , O'Driscoll Marie-Luce 
Published: May 2014

Massage is a treatment modality practised by physiotherapists, nurses, occupational therapists and other health and complementary therapists. This article examines the literature on the value of massage for inducing relaxation. The limited literature available suggests that massage can induce relaxation in oncology and mental health care, although findings were less clear in medical and critical care. The literature reveals a number of recurrent methodological weaknesses. Review and analysis of the literature forces the authors to conclude that because of the prevalence of inadequate reporting and apparent methodological flaws, it is not possible to confidently state whether or not massage can induce relaxation. Recommendations are made for further study to enhance existing research by performing large scale, high-quality controlled trials that detail methodological procedures fully.
Attention deficit hyperactivity disorder (ADHD) part one: a review of the literature
Authors: Chu Sidney 
Published: May 2014

Attention deficit hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders in childhood, affecting about 5% of the general childhood population in the UK. It is important for clinicians to have an up-to-date knowledge of the condition, and use evidence-based evaluation and intervention procedures to support this group of children. Part one of this article focuses on the diagnosis of ADHD as a specific childhood disorder. Information on the historical perspective of the disorder, current definition, diagnostic classification systems, primary clinical features, prevalence, aetiology, comorbidity and prognosis will be reviewed by integrating information from different current research studies. In part two, information related to evidence-based evaluation and intervention procedures provided by a multidisciplinary team will be synthesized by integrating information from different research studies.
Late presentation of choanal atresia
Authors: Gratero JF , Hobbs CGL , Youngs RP 
Published: May 2014

A 21-year-old man was referred to the ear, nose and throat outpatients with a 2-month history of sore throat and a right-sided neck lump, which had persisted despite antibiotics. On direct questioning, he was found to have a long history of right-sided nasal congestion and rhinorrhoea. He had previously had a nasal polyp removed from the right side 10 years before, but with no resolution in his nasal blockage. On examination there was a 1.5 cm soft, mobile, non-tender mass in the right anterior triangle. Direct inspection of the oral cavity and oropharynx was normal, while anterior rhinoscopy revealed a deviated nasal septum to the right. Blood tests were normal and an infectious mononucleosis screen was negative.Following a further course of antibiotics, he was reviewed in clinic showing some improvement in his throat symptoms while the neck mass remained unchanged. Flexible nasendoscopy was normal on the left side, but the scope could not be passed on the right. He was offered surgery for his nasal obstruction and under general anaesthesia, a rigid scope was introduced into the right nasal cavity and the diagnosis was made. A subsequent computed tomography (CT) scan confirmed right-sided choanal atresia (Figure 1).
An unusual case of polyuria in a lithium-treated patient
Authors: Green A , Clark JDA 
Published: May 2014

A 60-year-old woman, who had been taking lithium for 36 years for bipolar affective disorder, was referred to an endocrinologist by her psychiatrist for investigation of polydipsia and polyuria. Water deprivation did not concentrate her urine, nor did desmopressin, indicating the diagnosis of nephrogenic diabetes insipidus (NDI). She was started on chlorthalidone, a treatment for NDI, and her symptoms improved dramatically. Her polyuria was well controlled on chlorthalidone for 4 years, until she started feel tired and weak and her polyuria worsened. Initially these symptoms were attributed to her depression and lithium therapy. However, routine blood testing revealed a random blood glucose of 18.5 mmol/litre, thereby confirming the diagnosis of type 2 diabetes, and a corrected calcium of 3.02 mmol/litre (normal range 2.1–2.6 mmol/litre). She was started on a diabetic diet, resulting in good diabetes control (confirmed by haemoglobin A1c) and her symptoms improved. The patient's chlorthalidone was stopped as thiazide diuretics can cause hypercalcaemia and her calcium was repeated. The repeat value was higher at 3.07 mmol/litre and her parathormone was alsoelevated at 11.24 pmol/litre, confirming hyperparathyroidism. A parathyroid adenoma was sought but a nuclear medicine scan (Tc99m ssesta-MIBI; technetium 99m-sesta 2-methoxy isobutyl isonitrille) and ultrasound examination of the neck failed to localize an adenoma. It was felt that she had developed parathyroid hyperplasia secondary to chronic lithium therapy (Mallette and Eichhorn, 1986), so her lithium was withdrawn and replaced with sodium valproate. Her NDI and hyperparathyroidism resolved on withdrawal of lithium.