bluuebunny/crossref_metadata_2025_split huggingface dataset:
When to allow or deny adult access to children's health records
Authors: Griffith Richard , Tengnah Cassam 
Published: May 2014

The Data Protection Act 1998, section 7, has long granted patients the right of access to their health records. The right is exercised by a subject access request and a person with parental responsibility may exercise this right on behalf of a child. However, once the child is considered Gillick competent then a subject access request to a child's records must only be granted with the consent of the child. In this article the author sets out the requirements for a subject access request and why community nurses and specialist practitioners must proceed with caution when a request is received in respect of a child from the age of 12 years.
Group reminiscence therapy for adults with dementia: a review
Authors: Blake Marianne 
Published: May 2014

Dementia is an increasingly prevalent and costly condition in the UK. This review aims to explore the potential effectiveness of reminiscence group therapy as a non-pharmacological tool for reducing depressive symptoms commonly associated with dementia. The aim of this review is to explore existing literature regarding adults diagnosed with dementia, who are experiencing depressive symptoms, and the effect of reminiscence group therapy on their experience. A limited systematic search of four databases and hand search of titles, abstracts and reference lists revealed scarce evidence. A total of four original research articles, which met the inclusion and exclusion criteria, were accepted for critical appraisal. The overall quality of the studies was poor and use of multiple data collection tools made comparison difficult. All studies obtained some significant findings in favour of the effect of reminiscence group therapy. The primary recommendation of this review is for further high-quality research.
Juxta CURES: compression for healing venous leg ulcers
Authors: Nugent Lisa 
Published: May 2014

Clinicians are expected to show improved healing rates, reduction in recurrence rates and to demonstrate greater patient satisfaction. All patients should rightly expect a high standard of holistic care that supports both their physical and emotional needs. Keeping the patient engaged in the ‘healing process’ has many beneficial outcomes, not least to their emotional wellbeing. Managing to heal the wounds within a realistic timeframe is the required outcome for all parties. This article demonstrates how a new compression device, Juxta CURES, has a positive impact on patients' quality of life, also benefiting the clinician while maintaining cost-saving efficiencies.
Communication: making sense of what people with dementia say
Authors: Hobson Pat 
Published: May 2014

Dementia is a disorder that affects the person's ability to process language and information in such a way that will enable them to communicate their physical needs, feelings and emotions. This can lead to frustration for both the healthcare assistants (HCAs) and, most importantly, the person with dementia. The main focus should be on the HCAs developing the ability to enter the world of the person with dementia and adapt their ways to enable them to make sense of what the person is attempting to communicate ( Hobson 2008 ). What should be avoided is an attempt to continuously bring the person back to a reality that at best no longer makes sense to the person and at worst can be a frightening and distressing experience. Learning Outcomes: Links: QCF: Level 2 and 3 Shared Units: Dementia Pathway Level 2 DEM 201,202,204,205,210,211,301,308,312,313
Support workers as leaders: yes, you can …
Authors: Stonehouse David 
Published: May 2014

This is an article written following a presentation given at a national conference on the ‘Progression and Development in the Role of Support Workers’ in November 2012. Within this article, the author will highlight the important leadership role that support workers can and need to embrace. The article is aimed at three groups: first and most important, support workers themselves; second, managers; and third, educationalists in charge of developing and delivering both in-house and external training courses. Two key areas will be discussed where leadership by support workers is vital: quality and the management of change. The article will finish by looking at how support workers can be supported and developed within this often new role by managers and educationalists.
Hearing loss in people with learning disabilities
Authors: McShea Lynzee 
Published: May 2014

People with learning disabilities are more likely to have a hearing loss than the general population, but are less likely to have their hearing problem diagnosed or managed. Difficulties in access, misconceptions around assessment and a lack of aftercare are all factors in this.Undiagnosed hearing loss can cause significant problems in the life of a PWLD. Without training and education, carers do not have the expertise to detect hearing loss and manage hearing aids adequately. Even basic training could make a difference and a simple checklist to identify possible hearing difficulties is presented. Further research is needed in this area.
The pursuit of better performance
Authors: Cowper Andy 
Published: May 2014

Lord Hunt of Kings Heath OBE is Parliamentary Under-Secretary of State in the Lords for the Department of Health. His remit includes performance and clinical quality (including the performance and quality taskforces); medicines and medical devices; genetics and biotechnology; R&D, statistics, IT; executive Agency Management; departmental management; and the Eastern and North West Regions. Prior to his ennoblement, Philip Hunt was Director of National Association of Health Authorities and Trusts (the predecessor to the NHS Confederation).
Needs and priorities in dental care
Authors: Richards Wayne 
Published: May 2014

This article argues that rationing is an inescapable part of the provision of publicly-funded dental care at two quite distinct levels, and is likely to remain so. This rationing is based on a flawed model of service provision. Present patterns of service provision create and sustain a double jeopardy for certain socio-economic groupings. An evolutionary model of service provision is suggested to facilitate equitable service delivery.
Young carers and end of life services
Authors: Gandy Rob , Wilford Sara , Alexander Aileen 
Published: May 2014

In 2009, the NHS National Centre for Involvement and Liverpool Primary Care Trust undertook a national pilot project to establish how best to undertake patient and public involvement in respect of end of life (EOL) services. This article describes the outcomes from its sub-project which focused on young carers. It is projected that there are substantial numbers of young carers in the UK, at any one point in time, supporting their (grand)parents, or other adult family members, during their terminal illness. Interviews with young carers were conducted to gain understanding of their experiences of EOL service delivery by carers and professionals, and what support they felt they needed themselves. It was found that young carers were often inadvertently marginalised and at times felt ‘invisible’ to those providing care to the patient. Young carers require the same consistent, accurate and honest information as adult carers. Carers and professionals need to talk and listen to them, and to recognise the importance of the whole family, in the care of the patient. Local young carer's services can provide support and information, but there are many organisations that could also provide greater support including schools, social services, and health professionals.
An investigation of patients and providers′ views of services for motor neurone disease
Authors: Brown Janice B , Lattimer Valerie , Tudball Tracey 
Published: May 2014

The aims of this study were to investigate whether health and social care services met the needs of patients with motor neurone disease (MND) and their carers, to explore their preferences for service delivery and to compare these preferences with the services provided locally. Design : Structured interviews were conducted with 11 patients and 9 family carers living in three counties in southern England. A questionnaire survey of 17 commissioners from primary care trusts and social care was undertaken to collect detailed information about the scale and scope of local services. Results : Patients and carers consistently praised professionals′ efforts but identified deficiencies in professionals′ knowledge of MND and the organization of health and social care services, including the availability of key workers, respite care and specialized equipment, the speed of services, counselling and emotional support, and patients and families′ limited involvement in service evaluation. Conclusions : The three most important ways of improving services for patients with MND and other life-limiting neurodegenerative diseases would be the introduction of knowledgeable, specialist primary neurological care teams; a requirement for interprofessional and multi-agency cooperation; and active involvement of patients and carers in service development.
An introduction to neuroethics: Part 1. The values of ethics and the neurosciences
Authors: Stanley Robert , Gallagher Ann , Eberhardie Christine , Wainwright Paul 
Published: May 2014

This is the first in a series of seven articles that comprise an introduction to the understanding and application of ethics in the neurosciences. Neuroethics encompasses the ways in which developments in neuroscience intersect with social and ethical issues. There is no universal definition of neuroethics, although two broad categories of issues can be discerned: those emerging from what we can do and those emerging from what we know. Ethical problems follow from advances in neuroimaging, psychopharmacology, brain implants and brain-machine interfaces, but are also raised by growing understanding of the neural basis of behaviour, personality, consciousness, and transcendent states. This series of articles is intended to help practitioners explore neuroethics in their own practice. In this first article, advances in neuroscience are described and the need for ethical inquiry in the subject is discussed. Definitions of neuroethics are considered, as are implications for nursing practice. Several questions are raised, including: Should we limit the degree to which we can use neurological information in evaluating individuals in regulatory, legal, medical or commercial contexts? Should we undertake certain kinds of neuroscience experiments in view of the possible misuse of the results? How should we discriminate between treatment (medication to treat depression) and enhancement (medication to improve cognition in a person of normal intelligence) What does it mean to have a brain?
Advances in brain tissue oxygen monitoring: Using the Licox system in neurointensive care
Authors: Helliwell Roni 
Published: May 2014

The care and management of a traumatic brain-injured patient continues to present many challenges to the bedside practitioner. As technology is integrated into intensive care management it has become clear that maintaining conventional intracranial pressure and cerebral perfusion pressure levels will not always prevent cerebral ischaemia. The Licox Brain Tissue Oxygen Monitoring System offers a direct, accurate, real-time, regional partial pressure measurement of oxygen levels in brain tissue. The information gained from this monitoring system will provide an early warning of oxygenation problems that can contribute to secondary injury. When Licox is used in combination with other neurointensive care monitoring parameters it can help inform the bedside practitioner in making decisions about the choice of interventions and in assessing their effectiveness.
Excessive daytime sleepiness in a prevalent population of people with Parkinson’s disease
Authors: W Walker Richard , Hand Annette , L Cookey Ibifuro , K Gray William 
Published: May 2014

Background: The aim of this study was to evaluate the extent and nature of sleep problems in a community-dwelling cohort of people with Parkinson’s disease (PD). Methods: Cases were identified from a prevalence study. Participants were assessed for excessive daytime sleepiness using the Epworth sleepiness scale and were also asked a series of questions related to their nocturnal sleep pattern. They were also assessed using a number of standard rating scales. These included the Unified Parkinson’s Disease Rating Scale, the 39-item Parkinson’s Disease Questionnaire, the Mini-Mental State Examination and the Hospital Anxiety and Depression scale. Results: Of 75 participants, 31 reported the quality of their sleep to have deteriorated since being diagnosed with PD (41.3%), 20 participants had excessive daytime sleepiness (26.7%). Excessive daytime sleepiness was significantly associated with greater disease progression, reduced cognitive function, lower quality of life and greater depression. Excessive daytime sleepiness was only weakly associated with a report of a deterioration in the quality of sleep. Conclusions: Excessive daytime sleepiness is a common problem in people with PD and is associated with a range of other motor and non-motor symptoms.
Student midwives' views of the objective structured clinical examination
Authors: Rennie Anne Marie , Main Martyn 
Published: May 2014

Educational researchers have established beyond doubt that assessment greatly influences learning. However, the assessment of practical skills is complex and presents difficulties. Research in other disciplines has shown that the objective structured clinical examination (OSCE) is an effective evaluation tool to assess practical skills. The creation of a clinical skills laboratory within the educational setting, that simulates clinical reality, can enable experiential learning to occur. Most OSCE research so far has been focused on medical and nursing students, not midwifery students. This work focuses on student midwives’ views of the OSCE in order that future OSCE processes could be advanced. Three main themes to emerge from the data were: practicalities of running the OSCE, preparation for the OSCE assessment and the impact of assessors, volunteers and simulation on OSCE performance, all of which impacted on levels of anxiety for the student midwives.
Perinatal depression: its absence among Black Caribbean women
Authors: Edge Dawn 
Published: May 2014

Anecdotal evidence from clinical practice suggests that Black Caribbean women rarely consult with symptoms of perinatal depression. Reasons for this are unclear. Unlike White British or South Asian women, there has been little perinatal research within this ethnic group. In-depth qualitative interviews with a purposive sample of Black Caribbean women were undertaken in order to gain insight into the factors which might account for this phenomenon. The sample was drawn from a larger mixed-method, comparative study of prevalence and risk factors for perinatal depression among both Black Caribbean and White British women in the northwest of England (Edge et al, 2004) Interviews were audiotaped, transcribed and analysed thematically using QSR NUD*IST4 to facilitate data management. Findings suggest that women's beliefs about mental illness underpinned by personal and socio-cultural attitudes to help seeking might act as barriers to accessing primary care mental health services. Additionally, service provision, antenatal education and the attitudes of some health professionals might prevent women from this ethnic group receiving care and treatment for perinatal depression. The confluence of structural, socio-cultural, and personal barriers might account for the apparent absence of Black Caribbean women from those receiving treatment for perinatal depression.
Developing a specialist midwife practitioner in Russia
Authors: Walton Irene , Essay Rosemarie , Morgan Jane 
Published: May 2014

In Russia poor maternal and perinatal mortality and morbidity rates are coupled with a declining birth rate (World Health Organization, 2005). In order to improve outcomes for women and their babies there was an identified need to improve the knowledge and skills of midwives. Funding was secured for a collaborative educational project that aimed to educate specialist midwives in order to develop a woman-centred, innovative and evidence based approach to care. Outcomes were identified to include role specification, skills for the specialist midwife and strategies for teaching and learning. A curriculum was developed and learning outcomes identified and the programme was delivered using a variety of teaching methods. The midwives chose a clinical topic and identified key issues for change. Twenty-five midwives from eight institutions took part. The programme was successfully evaluated and further developments were identified from the project.
Women's experiences of following advice to stay at home in early labour
Authors: Nolan Mary , Smith Julie 
Published: May 2014

The aim was to explore women's experiences of staying at home following advice from an obstetric triage unit. Semi-structured interviews were undertaken with eight women who contacted a triage unit in early labour and were advised to remain at home; interviews were analysed using thematic analysis. Four themes were identified: reassurance (the need to have labour validated by health professionals); uncertainty about early labour; pressure from women's families to go to hospital; and seeking permission to come in. The overall theme reflected women's sense that advice to stay at home was a professional rather than a woman-centred response to early labour. Advice from midwives to stay at home in early labour may be insufficient to reassure women who lack trust in their own ability to interpret what is happening in labour, and who depend on health professionals. Until women's own faith in their ability to labour and give birth can be restored, women may feel obliged to stay at home in early labour, rather than feeling comfortable to do so.
Cultural diversity and dementia in Scottish care homes
Authors: Mullay Steve , Schofield Pat , Clarke Amanda , Primrose Willie 
Published: May 2014

Background:theoretical guidance and policy directives emphasize the necessity of considering the culturally-specific needs of health and social care service users as part of ‘person-centred’ approaches to care. This article outlines the ideas underpinning an ongoing PhD study of the interactions between care staff and residents which is aimed at gaining insights into how person-centred care is fulfilled for people with dementia in Scottish care homes.Discussion:certain dynamics may constrain the deployment of culturally-meaningful care approaches for certain service users in Scottish care homes. These include limited understandings of the nature of cultural diversity in modern Scotland, failure to recognize the import of ‘inter-generational’ cultural change, lack of research around the interactions between staff and service users from different cultural backgrounds, and a sketchy demographic picture of the ethnic/cultural composition of Scottish care home populations. Groups of service users in particular settings (such as older people with dementia in long-term care) may be especially vulnerable to the effects of care processes constituted under such circumstances.Conclusion:poorly recognized gaps in understanding of the sociocultural and historical influences which help constitute ‘the person’ in many Scottish care home residents may exist. If these are found to constrain ‘knowing the person’, can the term ‘person-centred’ be meaningfully applied to care?
Spirituality in nursing: a systematic review of the literature from 2006–10
Authors: Pike Joanne 
Published: May 2014

Spirituality in nursing care has been discussed for many years in the nursing press. There has been no literature review that explores only UK literature, and this article updates a literature review carried out in 2006 ( Ross, 2006 ).Aim:The review was designed to investigate the current nursing evidence underpinning the concept of spirituality and its application.Method:A systematic review of the literature was undertaken and a thematic analysis performed following a search for literature using defined dates, databases and search terms.Results:Four major themes emerged from the literature: concept clarification; spiritual care-giving; religion and spirituality; and nurse education.Conclusion:Definitions of spiritual care vary, and the concept of spirituality in nursing is still under development. However, until a common language of spirituality is developed, models of spiritual care developed through research involving mainly nursing staff will be difficult for nurses to apply.
Why is the regulation of advanced practice essential?
Authors: Brook Simon , Rushforth Helen 
Published: May 2014

For many years, nurses have sought to define advanced practice (AP). There is now a developing consensus that it should be broadly defined in ways which include and embrace not only clinical practice, but also other domains such as education, management and leadership. This broad definition is congruent with Benner's notion of the novice to expert trajectory and lends support to the view that the risks around AP are minimal, since advanced practitioners by definition have expertise. The broad model of A P, however, ignores one distinct subset of advanced practice nurses who we term nurse practitioners (NPs). NPs are distinct because of their hybrid, quasi-medical practice, which crucially involves autonomous medical diagnosis and treatment. The risks in this area of practice are substantial, and consequently require nothing less than a nationally-regulated set of benchmarks. These must address the training, assessment and registration of NPs for the primary purpose of public protection.
An aging renal population – is dialysis always the answer?
Authors: Noble Helen 
Published: May 2014

As people age and live for longer they are more likely to develop comorbid conditions including chronic kidney disease (CKD). This paper discusses the treatment options for stage 5 CKD including haemodialysis, peritoneal dialysis, transplantation or conservative management, also known as supportive care, for those who decide not to undertake dialysis. It also highlights the complexity of offering a treatment such as dialysis, viewed as a requirement to prolong life, without which people will die, which is unable to restore the kidneys to normal function, only substitute for.Dialysis is also an arduous therapy known to shorten life. In the past refusal of dialysis was viewed as akin to suicide and it is not until more recently that the needs and experiences of those who decide not to embark on dialysis have started to be recognized. Clearly dialysis is not suitable for all, particularly those who are frail with multiple comorbidities and so supportive and palliative care may be a more suitable option for some.