bluuebunny/crossref_metadata_2025_split huggingface dataset:
The non-pneumatic anti-shock garment for postpartum haemorrhage in nigeria
Authors: Ojengbede O , Galadanci H , Morhason-Bello IO , Nsima D , Camlin C , Morris JL , Butrick E , Meyer C , Mohammed Aminu I , Miller S 
Published: May 2014

Objective: This study examines whether the non-pneumatic anti-shock garment (NASG) reduces blood loss and mortality from uterine atony. Method: The sample was taken from delivering women at four referral facilities in nigeria who suffered obstetric haemorrhage, from which a subset of women with aetiology of post-partum uterine atony were examined. Data were collected by hospital staff and included 139 women, 54 in the pre-intervention phase and 85 in the NASG intervention phase. Differences in demographics, condition on study entry, treatment and outcomes were examined. Relative risks and 95% confidence intervals were used for primary outcomes of blood loss and mortality. Results: Median measured blood loss decreased from 360 ml pre-intervention to 30 ml in the NASG phase (P < 0.001). Mortality was reduced 72% for women treated with the NASG from 16.7% pre-intervention to 4.7% during the NASG phase (relative risk = 0.28, 95% confidence interval 0.09–0.87). Conclusion: The NASG shows promise for reducing blood loss and death from haemorrhage and shock due to uterine atony.
Preferences for traditional or modern practitioners: A comparative study
Authors: Akpabio Idongesit I. , Edet Olaide B. , Etifit Rita E. , Robinson-Bassey G.C. 
Published: May 2014

Objective: This study compared two groups of women—those with a preference for traditional birth attendants (TBAs) and those with a preference for modern health care practitioners (MHCPs)—at Akpabuyo, Cross River state, Nigeria with regard to their level of knowledge about the risks of patronizing the TBAs; perception of costs of services; educational qualifications; traditional beliefs; and income status. Method: A comparative descriptive design and a multistage systematic random-sampling technique were used to study 300 women of child-bearing age, 18–45 years, who had delivered at least one baby or were pregnant and residing at the study area. A validated questionnaire was the instrument for data collection. Results: Most of the participants, 156 (52.0%), had primary education, 113 (37.7%) had secondary education, 26 (8.7%) had tertiary education and 5 (1.7%) had no formal education. There were statistically significant differences between the two groups of respondents with regard to knowledge of the risks involved in patronizing TBAs; perception of costs of delivery with MHCPs; traditional beliefs; and income levels (Cal. t =3.26; 4.96; 6.61 and 3.88 > Crit. t = 1.96; df 298; P = 0.05). Women with a preference for MHCPs had a higher mean score (mean = 3.78) for knowledge; perception of lower cost of delivery services with MHCPs (mean = 7.57); lower adherence to traditional beliefs (mean = 5.25) but poorer and lower income level (mean = 1.12) compared with those who preferred TBAs (mean = 2.99; 8.88; 6.33 and 1.75 respectively). Most of the respondents (n = 54; 67.5%) whose educational level was below secondary education preferred TBAs compared with 113 (51.4%) of those with secondary education and above who preferred MHCPs. Conclusion: Recommendations focused on improvement of women's educational level to enhance their decision-making abilities with respect to choice of delivery services.
Unintended pregnancy, unsafe abortion and emergency contraception
Authors: Shewamene Zewdneh , Legesse Befikadu , Wodajo Derbe 
Published: May 2014

Purpose: The aim of this study was to examine the magnitude of unintended pregnancy, unsafe abortion and to assess awareness towards emergency contraception (EC) among women attending antenatal care in Ethiopia. Method: A cross sectional study was conducted from 19 August to 30 September 2011 among 310 women attending antenatal care (aged of 15–49 years) that were selected by using simple random sampling technique. A structured five page questionnaire was developed and pretested before the interview. The data were entered and analysed using SPSS version 16.0. Result: Of 310 respondents, 87 (28%) reported their pregnancy was unintended and 56 (18%) had practiced unsafe abortion one or more times. Only 105 (34%) of respondents had heard about EC and of those, only 11.8% had used the method previously. Of the 105 respondents who had heard about EC, 80 (76.2%) did not know the maximum acceptable time to use EC after unprotected sexual intercourse. A considerable proportion of respondents (59.1%) reported their fear on using EC due to safety misconceptions. Conclusion: This study indicated unintended pregnancy and unsafe abortion are very high due to lack of knowledge, practice and misconception towards EC among women attending antenatal care. Therefore, it is necessary to promote EC awareness using appropriate education methods.
Sleep disturbances in pregnancy, length of labour and type of delivery
Authors: Ali Akbari Sedigheh Amir , Bolouri Bayan , Najafi Arezu , Haghighi Khosro Sadeghniiat , Majd Hamid Alavi 
Published: May 2014

Background: Sleep patterns in pregnancy are often affected at different times for many reasons. Approximately two thirds of pregnant women complain of their sleeping patterns. Such problems impose further physical and psychological strain on women. This can influence the length and nature of labour and the type of delivery. This study was conducted to determine the association between sleep disturbances in the last month of pregnancy, the length of labour and type of delivery. Methods: A sequential non-randomised sampling method was used in this cohort study. This study followed 139 women (59 without sleep disturbances and 85 with sleep disturbances) in the last month of pregnancy until delivery. Demographic, obstetrical characteristics of mothers and items regarding general sleep disorders were collected using a questionnaire and observation checklist. SPSS software (version 18) was used for data analysis. Results: The mean duration of the first stage of labour in women with sleep disturbances was 65 minutes more than those who did not experience sleep disturbances. In the second stage of labour, the mean duration in sleep disturbed women was 25 minutes more than the control group (P<0.001). The difference between mean duration of third stage of labour in the two groups was not significant (P>0.05). The results also showed that caesarean section among the disturbed group was 2.7 times greater than in the other group (CI=0.83–8.5, RR=2.7). Conclusions: Sleep disturbances in pregnancy were found to negatively affect the duration of the first and second stages of labour. It may also influence the type of delivery; however, more research is needed on this subject.
The use of digoxin in the treatment of arrhythmias and heart failure
Authors: Chung Christine 
Published: May 2014

Digoxin is one of the oldest cardiac medicines still used in current practice. Over the years its place in the treatment of arrhythmias has changed following the advent of other anti-arrhythmic medications which have comparable effectiveness and tolerability. Digoxin inhibits the Na+-K+ pump and Ca2+ currents in the atrioventricular node and has a relatively slow onset of action when compared with other anti-arrhythmics such as β-blockers and calcium channel blockers. Its narrow therapeutic window requires serum levels to be taken for reasons such as the exclusion of toxicity. Digoxin is indicated for ventricular rate control in fast atrial fibrillation (AF) but it is ineffective in in cardioverting patients. It is not indicated for paroxysmal AF, where it may, in fact, worsen the condition. Digoxin is proven to benefit patients with heart failure and it should not be withdrawn from patients whose condition has previously been stabilized on digoxin.
The physical and psychosocial impact of being an unpaid carer for a heart failure patient
Authors: Whittingham Katharine 
Published: May 2014

By offering case management throughout the unpredictable patient journey the specialist heart failure nurse is pivotal in nurturing relationships with carers and is seen as an essential point of contact. Yet to date evidence of this aspect of the service is not collated formally. There appears to be limited information about the carer profile in heart failure including the activities they undertake and the impact it has on their lives. There is a lack of consensus about the guidance that should be provided to carers to support them in their role. This review examines the published literature relating to the demands on carers of heart failure patients (from 2000 onwards), briefly discusses how the heart failure specialist nurse assists in supporting carers with these demands and outlines recommendations for further work in this area.
Providing individualized education to patients post myocardial infarction: A literature review
Authors: Garvey Niamh , Noonan Brendan 
Published: May 2014

Aim: This article aims to review the published literature on providing individualized education to patients post myocardial infarction with focus on education methods. Background: Myocardial infarction (MI) is a leading cause of death worldwide. Patient education is vital to cardiac rehabilitation to reduce morbidity and mortality. Many factors increase a patient’s risk of reoccurrence of MI including smoking, obesity, hypertension, high cholesterol and sedentary lifestyle. Cardiac rehabilitation is vital to increase patient’s awareness of risk factors in order to improve their chance of recovery and survival. The participation of patients in their own care has also been shown to improve cardiac rehabilitation. Research has demonstrated that information plays a vital role in patient recovery and prevention of further MI. Nonetheless, research studies continue to conclude that patient education needs are not being met. Conclusions: In this literature review individualized education was identified as the most effective rehabilitation for MI patients. Patient education needs, preferences, social factors and stage of recovery need to be individually assessed. Only then can education specific to the individual patient be compiled and the most appropriate education method chosen through which the information can be delivered. Relevance to clinical practice: Nurses are in a prime position to assess patient education needs and with the help of evidence-based practice and research findings, nurses can implement cardiac rehabilitation programmes that will provide the most effective education for the individual patient and family.
What is patient and public involvement really like?
Authors: McGregor Suzanna , McCray Janet 
Published: May 2014

This study compares the actual experiences of patient representatives, with government legislation and policy on patient and public involvement (as outlined in the Health and Social Care Act 2001, and the Local Government and Public Involvement in Health Act 2007). The research was time-limited and small-scale and comprised a focus group, six formal and two informal interviews with cardiac patients who had completed the British Heart Foundation (BHF) Hearty Voices training. One of the most prominent findings of the study was that patients who had a varied role and were at a more strategic level in representation reported feeling most rewarded in their efforts.
Conducting a nurse consultation
Authors: Perry Graham 
Published: May 2014

Until recently it was doctors who patients saw for consultations in the outpatients department of hospitals or in general practice. Over the past three decades there has been a dramatic rise in the number of specialist nurses within the health-care setting i.e. the development of the consultant nurse, advanced nurse practitioner and clinical nurse specialist. Many of these roles have evolved in response to the developments in medical care and the advancement of medical technology. The success of the nurse consultation depends not only on the clinician’s clinical knowledge and interview skills but also on the nature of the relationship that exists between the nurse and patient. Increasing emphasis is now being placed on communication skills alongside history taking in postgraduate courses for nurses to enhance the nurse–patient relationship and promote more effective consultations. How nurses portray themselves is just as important as what they say. The patient needs to feel sufficiently at ease during the consultation to disclose any problems and express any concerns. The patient also needs to reach a shared understanding with the nurse about the nature of any illness, any investigations planned and what treatment is proposed to deal with it. As well as being more supportive for patients, good communication skills make taking the patient’s history more accurate and effective.
Acute management of right ventricular infarction
Authors: O’Donovan Kate 
Published: May 2014

Right ventricular infarction is commonly seen in the presence of inferior ST-segment elevation myocardial infarction (STEMI) but its recognition and diagnosis is a clinical challenge. Right ventricular infarction has been described in up to 50% of patients with acute inferior STEMI with the majority of patients remaining asymptomatic and clinically stable. The classic triad used to describe the clinical manifestations is hypotension, raised jugular venous pressure and clear lung fields on auscultation. A right-sided ECG demonstrating 1 mm ST elevation in V4R, which is transient, confirms suspicion of RVI. Treatment goals include prompt reperfusion, avoidance of medications that reduce preload, volume loading with the option of adding inotropic support or insertion of an intra aortic balloon pump. Prognosis is positive with the majority of patients recovering baseline right ventricular function in the months following the event. Clinical consequences of RVI include hypotension, bradycardia, conduction disturbances and depressed right ventricular function if not recognized promptly. Emergency and cardiovascular nurses have a pivotal role in the identification, assessment and treatment of these patients as they are commonly the first point of medical contact.
Smoking cessation: the heart of the matter
Authors: McEwen Andy , Grothier Lucy 
Published: May 2014

Smoking is the single biggest cause of preventable mortality and morbidity, doubling the risk of developing heart disease and other cardiovascular diseases. Smoking cessation significantly improves current and future health, but it is not easy to achieve due to the addictive nature of nicotine. Offering patients who smoke very brief advice on smoking can motive them to make a quit attempt; ensuring that a quit attempt takes place with the help of medication and behavioural support from a trained stop smoking practitioner will maximise the chances of these quit attempts being successful. Nurses are ideally placed to deliver these life-saving interventions. Training for health professionals in how to deliver very brief advice is available through the National Centre for Smoking Cessation and Training.
Compliance with lipid-lowering medication after diagnosis of coronary heart disease
Authors: McKellar Sandra , Fulbrook Paul 
Published: May 2014

Background Previous studies indicate that medication compliance within chronic disease populations, including coronary heart disease (CHD), is poor. Aim To determine lipid-lowering medication (LLM) self-reported compliance of CHD patients 12 months following hospital discharge. Methods Two 1-year follow-up studies were conducted in tertiary, private and public hospitals. A random sample of patients (n=211) diagnosed with CHD by angiography was recruited. Data were collected via telephone interview, using a standardised questionnaire. Results At 12 months, all private hospital participants were still taking LLM and only four public hospital participants had ceased LLM independently of medical advice. Conclusions: The high self-reported compliance found in this study is significantly better than previous research reports of 12-month compliance rates of around 50% in chronic disease populations. Several factors may be relevant, of which the most important may have been the positive influence of the National Heart Foundation of Australia guidelines, which specify early implementation of LLM.
Therapeutic touch
Authors: Benor Rita 
Published: May 2014

Therapeutic touch is a modern form of healing derived from the ancient art of ‘laying on of hands’. It was originated in America in the 1970’s by Dolores Keriger, and is grounded in research. The theoretic framework is within Martha Rogers’ nursing model, Science of Unitary Human Beings. The roots of therapeutic touch are in the laying on of hands. However, it is not performed within a religious context because in order for therapeutic touch to be effective, the practitioner is not required to have religious beliefs, and the recipient does not have to have faith or necessarily believe in the technique. An overview of these issues relating to therapeutic touch is presented in this paper.
Skillmix and community profiling in a general practice
Authors: Roberts Geoff , Anstead Elizabeth 
Published: May 2014

The progress of a fundholding practice is charted from its decision to implement skillmix through a new nursing management structure to the development of a multi-agency health and social needs profile. The nursing team developed a more participative, flexible and progressive approach to the use of nursing skills and role development in primary care. The multi-agency work produced greater collaboration between individuals at the grassroots. The practice described in this paper serves 10000 patients in a town in west Surrey with a mixed population. ‘Old Camberley’ has retired generals and others in large old houses, but there are also large estates of young families, a London overspill council estate built in the 1960s, newer small estates of large executive homes and a mobile population of army families.
Pressure sore risk: validating an assessment tool
Authors: Edwards Margaret 
Published: May 2014

A study was conducted within a South London community trust to establish whether the Waterlow Pressure Sore Risk Score could usefully assist district nurses in their allocation of pressure relieving equipment to elderly patients. In part one of the study 40 elderly patients with and without pressure sores were assessed by two community nurses, to measure the level of agreement. In part two, 31 randomly selected patients were followed up for eight weeks, at fortnightly intervals, to measure the ability of the Waterlow Score to predict pressure sore formation. High levels of agreement were not found. The findings indicate that the Waterlow Score should not be used as the sole basis for the allocation of preventive devices to this group of patients. However, the study did suggest that high to very high Waterlow scores may be a predictor of ill-health in the population. This hypothesis requires further investigation.
The use of IT in community health care
Authors: Harvey Trevor 
Published: May 2014

In the NHS the information follows the patient. As community nursing is information intensive, IT is likely to play an important role in the care of the patient, and community nurses may be required to transfer their IT skills to the new portable technologies. The power of sharing information, however, has yet to be realised, but promises among other things more rational care purchasing. Data integrity, security and confidentiality are top priorities and improved NHS data standards will eliminate any drawbacks.
Learning to support children with complex needs in their homes
Authors: Hewitt-Taylor Jaqui , Farasat Helen 
Published: May 2014

There are an increasing number of children with complex and continuing health needs. The aim is that wherever possible they and their families should be supported in a way which enables them to remain at home. A part of achieving this aim is increasing the competence and confidence which nursing staff have to provide such support. This paper reports on a pilot placement for preregistration nursing students focused on supporting children with complex needs in their homes. The major findings were that such a placement can be extremely beneficial in enabling students to develop practical skills and attitudes and values which will assist them to provide appropriate support. It also clarified some of the major organisational and practical issues which must be considered in facilitating such placements.
The Warrington workload tool: determining its use in one trust
Authors: Baldwin Melissa 
Published: May 2014

With recent advances in chronic disease management and with earlier discharge from the acute sector, it has become increasingly important for district nurses to monitor and evidence their increasing workload, to monitor demand and capacity. The district nursing service in the author's trust has employed an adaptation of the Warrington workload tool, over several years, to demonstrate and evidence their workload. However, many dispute the accuracy of such tools. This audit set out to discover how accurately the tool was being calculated. The findings have cast doubt on the tool's accurate completion and highlighted an ongoing training need to ensure improvement in its use. The tool is to be further supported with the inclusion of a caseload profiling tool to provide qualitative evidence of the service that the nurses now provide. It was also identified that the service needs evidence that their resource needs are met in response to workload tool data to ensure the tool continues to be used in a proactive manner.
Nutrition in palliative care
Authors: Acreman Sue 
Published: May 2014

Nutrition in palliative care and at the end of life should be one of the goals for improving quality of life. It is important to address issues of food and feeding at this time to assist in the management of troublesome symptoms as well as to enhance the remaining life. While this paper focuses upon the nutritional aspects of cancer in palliative care, the sentiments are applicable to other serious chronic illnesses such as advanced cardiac failure, chronic obstructive pulmonary disease and dementia. Cancer and its treatments exert a major impact upon physical and psychological reserves and at the end of life problems with appetite and the ability to eat and drink compound such impact. The aims of nutritional care minimize food-related discomfort and maximize food enjoyment. Identification of any nutritional problems can facilitate the employment of strategies which need to be discussed with the patient and their families and reviewed regularly as conditions change. Ethical questions will be raised concerning the provision of food and fluids to a person nearing the end of their life. Nurses need to acknowledge that food has greater significance than the provision of nutrients.
Focus on Parkinson's: causes, treatment and support
Authors: Heisters Daiga 
Published: May 2014

Parkinson's is a progressive neurological condition which can affect everyday activities such as walking and talking, with symptoms ranging from tremor, slowness of movement and muscle stiffness. Other non-motor symptoms include problems with sleeping, depression and anxiety and it is these that people with Parkinson's often find most debilitating. People with Parkinson's will have a carefully balanced combination of medication to control and manage their symptoms. The timing of this medication is crucial. Parkinson's can affect each person differently and is a fluctuating condition, the symptoms and effects of the condition the district nurse may see on one visit may not be representative of how the person is affected so it is vital that she speaks to family, friends and carers of the person with the disease.