bluuebunny/crossref_metadata_2025_split huggingface dataset:
Older people: how do they find out about their health?
Authors: Hurst Gill , Wilson Patricia , Dickinson Angela 
Published: May 2014

Information about health is gained from various sources, but little is known about the health information-seeking behaviours of older people and what factors affect this. This pilot study aimed to explore older people's experiences and views on their health information-seeking behaviours and to gain a better understanding of these. A qualitative study with 9 older people was undertaken, using diaries and semi-structured interviews to gather data. Three key themes emerged relating to why they sought information, what shaped this and where health information was accessed. This study is generating fresh knowledge of older people's experiences and views on health information-seeking behaviour. By understanding these, health professionals will be better placed to promote strategies that improve older people's access to appropriate health information and support its effective use.
Focus on the micro-relationship in the delivery of care
Authors: Gethin-Jones Stephen 
Published: May 2014

Recent reports have expressed concerns over the quality of care delivery in care settings and the homes of older people. This study followed 30 older people who had recently been discharged from hospital and were in the transition from re-ablement services to home care. The study focused on the non-clinical elements of care delivery (interpersonal relationships) and what the older patient felt was important in the delivery of their care. This was a qualitative study using semi-structured interviews to gather data on the interpersonal processes involved in the delivery of intimate care to vulnerable older patients. Three key themes were developed as to what the older patient felt was important for good-quality care. These were: The need for social interaction beyond the delivery of clinical healthcare tasks The need for consistent care staff in order to develop a working relationship The need for the older patient to feel they had some control over how their care was delivered. In sum, the patients needed to feel they were working with the care staff rather than purely having the care done to them.
Modernising the NHS: a game of two halves:
Authors: Peck Edward 
Published: May 2014

The ‘modernisation’ of the NHS is gathering pace. At the centre of this project, however, there seems to lurk a tension; which resides in the balance between central prescription and local discretion. This paper draws on the work of Marquand, 6 and Towell to suggest ways in which local modernisation boards can work with this tension in the pursuance of ‘modernisation’.
Online illness narratives about living with motor neurone disease: A quantitative analysis
Authors: O'Brien Mary R , Clark David 
Published: May 2014

Background: To date, no published work has sought to investigate internet-based writing about life with motor neurone disease (amyotrophic lateral sclerosis) or to determine who is using this genre to publicize their illness narratives Objectives: To identify and locate illness narratives written by people diagnosed with motor neurone disease posted on the Internet and to ascertain who is using this vehicle to tell the story of their illness. Method: Systematic searches were conducted using Internet search and Meta search engines, local and national motor neurone disease association information sites and by following links from personal websites and motor neurone disease chat rooms, newsgroups and forums. Results: Ultimately, 64 personal websites containing illness narratives written by people with motor neurone disease were identified. Demographic details of the authors are presented. Conclusion: This novel study demonstrates that health professionals can access an invaluable source of personal illness narratives from the internet using a systematic approach.
RESEARCH ROUNDUP
Authors: Eberhardie Christine 
Published: May 2014

Caring for children at home after severe traumatic brain injury Neuro-paediatric nurses working in acute and rehabilitation settings may find helpful this report of a small qualitative study into the day-to-day strategies of parental caregiving in children who have had a severe traumatic brain injury (TBI) defined as a GCS score of 3–8. It is a study carried out by occupational therapists in New Zealand.
Carers of patients with a primary malignant brain tumour: Are their information needs being met?
Authors: Arber A , Hutson N , Guerrero D , Wilson S , Lucas C , Faithfull S 
Published: May 2014

Providing care in the home is very demanding, particularly where people with a primary malignant brain tumour (PMBT) are concerned, as there are physical, cognitive and behavioural alterations that can make significant demands on family caregivers. Aim: The aim of this article is to consider carers' access to information following diagnosis of a PMBT and information on managing the caring role. Method: A grounded theory approach was used, with 22 open-ended interviews carried out with active carers at the time of the interview. Findings: Carers identified a lack of attention to their need for information particularly regarding medication, caring and working, and becoming a carer. They develop strategies such as using the Internet to search for information and support and using friends to filter information so they are not overwhelmed with depressing information. Using these strategies, carers reduce uncertainty, alleviate stress and find a way to continue to hope. Conclusions: Carers lack guidance on how to access information at different stages of the caring journey. However, they are resourceful in finding support and information and expect health services to include and signpost them to the most appropriate sources of information.
Access to care services for rural dwellers with idiopathic Parkinson's disease
Authors: Walker Richard , Sweeney William , Gray William 
Published: May 2014

Background and aims: This study aimed to assess the care use of people with Parkinson's disease (PD) living in North Northumberland a mostly rural area of the UK. Methods: during a single home visit, 106 people with PD identified by a prevalence study were invited to complete a questionnaire and semi-structured interview, providing demographic information and details of care services currently used. Results: 75 people agreed to participate. Ten patients (13.3%) were living in institutional care, representing 1.8% of the total nursing and residential care population in the study area. Of the 65 patients living in their own homes, 18 (27.7%) had domestic home care services provided and 17 (26.2%) used personal home care services. Conclusions: Living in a rural area appeared to be no hindrance to accessing care services when they were required.
Promoting the safe administration of immunoglobulins in neuroscience
Authors: Waterhouse Catheryne 
Published: May 2014

Intravenous immunoglobulins (IVIGs) have been used as a replacement therapy for primary immunodeficiency for many years. In other neurological systemic autoimmune conditions IVIGs have proven beneficial, often when the patient has been unresponsive to other therapies and interventions. While some conditions, such as Guillain Barré syndrome, can be managed with a single course, many other long-term/progressive diseases require repeated infusions. IVIGs are expensive and the cost is increasing, largely due to global shortages and increased demand. Measures to prioritize the use of the product are based on clinical need, where there is evidence of effectiveness and where the benefits outweigh potential risks. This paper aims to explain the mechanism of action of immunoglobulin therapy and review some of the benefits and risks associated with their administration.
Too choosy about choice: the responsibility of the midwife
Authors: Richards Jacqueline 
Published: May 2014

One of the priciple of good maternity care identified by the Expert Maternity Group, suggest that: ‘The woman must be the focus of…care. She should be able to feels that she is in control of what is happening to her and able to make decisions about her care, based on her needs, having discussed matters fully with the professionals involved.’ Calls for a shift in the balance of power, reassert the ethical principles — autonomy, justice, beneficence and non-maleficence. But what are the professional and legal constraints? How well can we fulfil this ideal? In meeting her clients' needs, the individual midwife faces conflict, and often accusations of negligence, radicalism or whistle-blowing. Her role as advocate, communicator, educator and facilitator is here examined.
Webwatch
Authors: Hassall Jenny 
Published: May 2014

Within the demanding current climate that many midwives find themselves working in, it is understandable that many are feeling disillusioned with the quality of care they are able to provide. This month's Webwatch reviews the website for the Association of Radical Midwives, a group of midwives, student midwives and others in the UK committed to improving the maternity care provided by the NHS. The site being reviewed can be found at: www.radmid.demon.co.uk/
Selecting students for midwifery education: is PBL the answer?
Authors: Meddings Fiona , Porter Jan 
Published: May 2014

Midwifery programmes attract a large number of applications with an ever increasing demand for the small number of places available. Higher Education Institutions (HEI) are concerned with attracting students who have the right attributes for a career in midwifery and who are likely to succeed on the programme. Potential students however are concerned with making the right choice of HEI where they will be comfortable spending three years working towards attaining a degree in midwifery. The University of Bradford has sought an innovative approach to the selection of students. The programme is predominantly taught through problem based learning, which enables the development of a range of skills that will benefit them in professional practice. Personal attributes required for this process can be identified at an early stage therefore a system has been introduced whereby prospective students are selected purely through the utilization of the problem based learning process.
When will we change practice and stop directing pushing in labour?
Authors: Cooke Alison 
Published: May 2014

There have been many papers written about the issue of pushing in the second stage of labour, and yet anecdotally some midwives are still restricted by labour ward policies of timed second stages, active pushing once fully dilated and subsequent interventions when time runs out. Research is fraught with frustration on occasion; some studies stop early because of preliminary findings indicating obvious benefits, while others, although offering beneficial findings, are often ignored and traditional practices continue. This article considers the research supporting spontaneous pushing in labour; it asks why change is so difficult and then considers what could be done to encourage a change in practice. The article finds that women should be allowed to push spontaneously. A change in clinical practice is recommended. It considers whether further research is necessary, or whether a change in the definitions used for the stages of labour would allow midwives to let women dictate when to push.
Clinical mentors' influence on student midwives' clinical practice
Authors: Armstrong Nicola 
Published: May 2014

The aim of this study was to find out whether final-year student midwives were influenced by traditional (non evidence-based) practices of their clinical mentors. Questionnaires were used to collect data from 145 students from five different universities spread across the North of England. Despite students having perceived that the higher education institution (HEI) advocated evidence-based practices (EBP), the majority of students felt that what was taught in the HEI, did not always correspond to what happened in the workplace. Most agreed that within the clinical setting there were some practices that were based on tradition and agreed that some of these practices were good because they appeared to work. While the majority of students indicated a preference towards using EBP, the findings suggested that, where there was an embedded use of traditional practice within the workplace, the students were more likely to adopt these traditional practices of their mentors. While statistically most perceived they would challenge their mentors if they did not employ EBP, their comments overall conflicted with these findings, as many felt that by challenging their mentors they might jeopardise their clinical assessments and career prospects.
Improving practice: women's views of a maternity triage service
Authors: Molloy Cathy , Mitchell Theresa 
Published: May 2014

A new triage service was initiated in an acute trust in southwest England to assess women who presented with a problem in their pregnancy but who did not necessarily require admission to delivery suite. Questionnaires were used to obtain the views of women using triage and to identify areas which they thought were good practice and also identify those areas that required improvement. Data were analysed using the SNAP survey software which enabled basic features within the data to be described. Most women were happy with the amount of time they waited in triage which appears to negate the need for appointments. Women were satisfied with the amount of time they spent with the midwife and obstetrician and reported being treated with dignity and respect, although there were some problems relating to the triage environment.
The complexities of supporting teenagers in pregancy
Authors: Thompson Sue 
Published: May 2014

This article describes the multifactorial issues that are involved when providing appropriate care to teenagers who become pregnant. The teenage pregnancy clinic was set up over 10 years ago in Liverpool by an innovative midwife, Lorna Wood, with the support of a consultant obstetrician. The pregnant teenager's journey begins at the booking in visit, continuing throughout antenatal care and ends at the postnatal visit, approximately 6 weeks after the birth. The article highlights the importance of the careful, accurate assessment of each individual in order to provide an optimum, flexible plan of care for both mother and baby. The success of the clinic can be measured in many ways, not least the very low rate of non-attendance. The outcomes are good and the rate of repeat pregnancies is low, (less than 3% each year). This is in part owing to the provision of contraception at the postnatal visit and continuity of care throughout by the two midwives involved.
What is in the bag? Birth essentials for the independent midwife
Authors: Hughes Kim 
Published: May 2014

Midwives attending home births carry essential obstetric equipment to monitor the wellbeing of mother and baby and to deal with problems that may occur unexpectedly at birth. This article looks at the obstetric equipment needed and used by midwives in the community, from the perspective of a midwife based in an independent practice in Yorkshire.
Secure transfer of postnatal information: The STOW project
Authors: Morris-Thompson Trish , Easton Suzanne , Read Jessica , Marks-Maran Di 
Published: May 2014

In London, it is estimated that about 10% of women deliver in one NHS trust but receive postnatal care in another area. Transfer of postnatal information about women and babies is done via fax. A more reliable method of communication was needed. A pilot project, the Secure Transfer of Women (STOW), was undertaken in four NHS trusts in north London to test the transfer of postnatal information via email, using NHSmail between the maternity units. Communication with other NHS trusts would continue via fax. Training and IT support was provided in the pilot NHS trusts. An evaluative study undertaken showed that members of staff liked the system. They felt that email transfer improved the service for mothers and babies. Maternity units also received fewer calls from mothers to say that they had not yet had their postnatal visit. Postnatal transfer of information via email is now being rolled out across London.
Retained vaginal swabs: review of an adverse event in obstetrics through closed claims analysis
Authors: Healy Patricia 
Published: May 2014

Background: An integrated approach to clinical risk management and litigation claims management in the health service is essential to drive and support safe patient care. This approach identifies adverse events and enables learning from those events. Objective: To explore the issue of retained vaginal swabs in the maternity services and to identify common themes and areas for improvement. Methods: Closed claims analysis using retrospective review of legal case records held by the State Claims Agency in Ireland for the period 2004–2011. Subjects: Litigation cases handled by the State Claims Agency regarding alleged vaginal retention of a surgical swab following childbirth. Results: Review of the 16 closed cases revealed 3 major areas of concern; staff clinical performance, workload issues and documentation. Conclusion: Cases of retained vaginal swabs were few in number. However, they represent a significant problem in that they are very difficult to defend in clinical negligence litigation, as they reflect the failure of clinicians to comply with practice standards around a clinical procedure. Maternity service providers must put measures in place to manage this preventable clinical risk.
Introducing an obstetric emergency training strategy into a simulated environment
Authors: Hughes Clare , Anderson Gail , Patterson Dorothy , O'Prey Mary 
Published: May 2014

Midwifery educators are challenged to produce registrants who are fit for practice at the point of registration with competence at the heart of this expectation. In addition to achieving expertise in normal pregnancy, it is recognised that students need to have the skills of critical decision making where normal processes become adversely affected. An evaluation was undertaken with final year direct entry midwifery students using questionnaires and focus group interviews to determine whether simulated learning, such as the Practical Obstetric Multi-Professional Training (PROMPT) package, for emergency obstetric training would enhance self-efficacy and confidence levels in preparation for post-registration practice. The main themes that emerged from the study indicate that this style of learning increased midwifery students’ feelings of self-efficacy; highlighted the importance of a safe learning environment; reduced their anxiety regarding their ability to make decisions in clinical practice and reinforced confidence in their level of knowledge.
Study of peristomal skin disorders in patients with permanent stomas
Authors: Herlufsen Per , Olsen Anne Grete , Carlsen Bente , Nybaek Hanne , Jemec Gregor BE , Karlsmark Tonny , Laursen Troels Norgaard 
Published: May 2014

The aim of this article was to investigate the frequency, severity and diversity of peristomal skin disorders among individuals with a permanent stoma in a community population. All individuals with a permanent stoma (n=630) in a Danish community population were invited to participate in a cross-sectional study. A total of 202 individuals (101men; 101women) agreed to participate. Data were collected through questionnaires and clinical examinations. It was found that peristomal skin disorders were higher for participants with an ileostomy (57%) and urostomy (48%) than in those with a colostomy (35%). Of the diagnoses of skin disorders, 77% could be related to contact with stoma effluent. Only 38% of diagnosed participants agreed that they had a skin disorder and more than 80% did not seek professional health care. The study revealed a high frequency of peristomal skin disorders. Participants frequently failed to perceive that they had a skin irritation and did not seek help. This suggests that more education and perhaps regular, annual follow-up visits at local stoma care clinics are needed.Declaration of interest: This research was funded by Coloplast A/S, Humlebæk, Denmark.
Writing for professional publication. Part 1: Motivation
Authors: Fowler John 
Published: May 2014

Dr John Fowler wrote his first article for publication as a staff nurse 30 years ago. Since then he has published over 50 articles in a variety of publications, edited seven nursing text books and is the series editor for 20 books in the Quay Book’s ‘Fundamental Aspects of Nursing Care’ series. He has supported over 40 nurses in their early writing for successful publications Writing for professional publication can be a daunting prospect, but, with a little effort and the right motivation, it can be a rewarding and career-enhancing experience. And the good news is, it’s not as difficult as it may sound. In this first part of a series of articles on writing for professional publication, John Fowler, an experienced nursing lecturer and author, discusses perhaps the most important factor in seeing your work published: motivation. Forthcoming issues will explore different aspects of publication and include advice and practical tips
Prisoner health: HIV infection and other blood-borne viral infections
Authors: Peate Ian 
Published: May 2014

All prisoners should be entitled to the same standards of health care as the general population. This is the principle of equivalence. Inmates who are physically or mentally ill, addicted to substances, or disabled should receive equivalent care to what is expected of the NHS. There are a number of variations and inequalities in the health services that prisoners receive across the UK. A number of prisons have no policies in place for HIV, hepatitis C or sexual health. The prevalence of HIV is significantly higher in the prison population than it is in the wider community. This article considers and outlines the important principle of equivalence and the needs of the prison population in relation to HIV infection and other blood-borne virus infections. Methods used to minimize risk are described and the importance of development, implementation and evaluation of harm minimization strategies are discussed. The term ‘prison’ in this article is used to identify all places of detention in England and the term ‘prisoner’ is used to describe all adults who are held in such places. Prison services and healthcare provision in other UK countries are also outlined.
NPWT and moist wound dressings in the treatment of the diabetic foot
Authors: Yarwood-Ross Lee , Dignon Andree Marie 
Published: May 2014

Objectives: To compare the use of negative pressure wound therapy (NPWT) and conventional wound dressings in the treatment of diabetic foot wounds. This article reviews research that compares the two treatments on partial foot amputations, foot ulcers, infected wounds and dehisced post-surgical wounds. Methods: A systematic literature search was carried out using CINAHL, MEDLINE and the Cochrane Library to locate and critique key studies comparing NPWT and conventional wound dressings to determine their quality. Findings: NPWT was found to be more effective in treating diabetic foot wounds compared with conventional wound dressings. NPWT was quicker at forming granulation tissue, achieving wound closure, removing infection from foot ulcer beds and decreasing wound dimensions. Data also showed greater incidence of amputations in those patients treated with moist wound dressings. Implications: Findings suggest that NPWT could be used as a primary treatment for diabetic foot wounds. Factors such as cost effectiveness and patient acceptability may have an impact on this treatment and will need to be investigated in implementing NPWT into practice.