bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building the future: children's views on nurses and hospital care
Authors: Fletcher Terri , Glasper Alan , Prudhoe Gill , Battrick Cath , Coles Lesley , Weaver Katy , Ireland Lorraine 
Published: May 2014

Healthcare policies such as standard 7 of the National Service Framework for Children, Young People and Maternity Services and the new NMC standards for pre-registration nursing programmes emphasise the need for universities and their partner trusts to engage with patients and the public in developing both nurse training courses and services. This article describes a two-arm study into the views and experiences of children with regard to hospitals. Conducted as part of an ongoing commitment to the reconfiguration of children’s services and the development of a new undergraduate children’s nursing programme, the study collected data from 61 children in two children’s hospitals in the south of England and from eight members of a city youth parliament. Aims: The study sought to involve child users in service planning through two objectives: 1) to ascertain the views of children and young people on what skills, knowledge and attitudes, children’s nurses of the future will need to care for sick children and their families; and 2) to seek the views of young people on what children think about before being admitted to hospital, and subsequently as inpatients. Method: The study used a draw and write/tell technique. The main outcome measures were description and analysis of those attributes which children believe nurses of the future should possess, and of those factors which inhibit or enhance childhood hospital admission. Results: A number of themes emerged from analysis of the data: notably that children’s nurses of the future should be skilled in both verbal and non-verbal communication, as well as having fundamental clinical skills. Issues relating to children about to be admitted to hospital included being scared or worried, and fear of the unknown, while concerns after admission to hospital related to the care environment, social needs, and individual/ personal needs and requirements. Conclusions: This patient and public involvement study revealed a number areas that children and young people believe to be important for the future training of children’s nurses. Additionally, the factors which children consider inhibit or enhance the experience of hospital admission have been identified.
CINV in the UK: a prospective audit of patient experience
Authors: Vidall Cheryl 
Published: May 2014

Chemotherapy induces nausea and vomiting in a significant number of cancer patients across the world each day. Unfortunately patients tend to be at home and away from the specialist oncology centres when the symptoms are at their worst. This leads to a disconnect between what health professionals predict will happen to patients and what patients actually experience, especially in the delayed phase of chemotherapy-induced nausea and vomiting (CINV) ( Grunberg, 2004 ). Following feedback from a European forum (see preceding article, p. 22-8) that CINV is still poorly managed, the UK Oncology Nursing Society (UKONS) is proposing a nation-wide, multi-site audit of the patient-reported CINV experience by reviewing specially-designed CINV diaries. Each cycle of treatment will be recorded and side effects closely monitored for several days after treatment. Furthermore, the audit will assess the clinical prescribing habits, use of international CINV guidelines and variations in local protocols for these patients. An online survey will be undertaken by the clinical teams on what they predict a group of chemotherapy patients will experience by way of CINV. This audit will then be compared to the reported side effects experienced by the patients. It is proposed that this audit will provide evidence of how NHS and private oncology teams manage CINV within the UK.
Pain management in Jordan: nursing students' knowledge and attitude
Authors: Khalaileh Murad Al , Qadire Mohammad Al 
Published: May 2014

Pain management requires knowledgeable and trained nurses. Because nursing students are the nurses of the future, it is important to ensure that students receive adequate education about pain management in nursing schools. The purpose of this study is to evaluate nursing students' knowledge and attitudes regarding pain management. A cross-sectional survey was used. The sample comprised 144 students from three nursing colleges in Jordan. Sixty-one percent were female and the average age was 21.6 years (SD 1.7). The students' Knowledge and Attitudes Survey Regarding Pain was used. The rate of correct answers ranged from 11.1% to 64%. Students showed a low level of knowledge regarding pain management—the average score was just 16 (SD 5.11) out of 40. Students were weak in their knowledge of pain medications pharmacology (actions and side effects). Less than half of students (47.9%) recognised that pain may be present, even when vital signs are normal and facial expressions relaxed. Finally, students showed negative attitudes towards pain management, believing that patients should tolerate pain as much as they can before receiving opioids; almost half (48%) of students agreed that patients' pain could be managed with placebo rather than medication. In conclusion, Jordanian nursing students showed lower levels of pain knowledge compared with other nursing students around the world. This study underlines the need to include pain-management courses throughout undergraduate nursing curricula in Jordan.
Gastro-oesophageal reflux. Part 2: medical treatment
Authors: Talalwah Narmeen Al , Woodward Sue 
Published: May 2014

Introduction and Background: Gastro-oesophageal reflux disease (GORD) is a chronic disease characterised by retrograde movement of stomach contents into the oesophagus. It causes heartburn and oesophagitis and adversely affects quality of life. If left untreated it can lead to oesophageal stricture and carcinoma. The prevalence in Western countries is 30%. This paper presents a comparative review of the effectiveness of Omeprazole with Ranitidine for treatment of GORD. Methods: A search for English language studies on adults was conducted using three databases, MEDLINE, EMBASE and the Cochrane Central Register of RCTs. Thirty relevant studies were included in the review. Findings: Omeprazole is more effective in controlling heartburn symptoms, healing oesophagitis, improving quality of life and preventing relapses than Ranitidine, but takes time to reach therapeutic effect. Ranitidine is more effective at relieving symptoms on an as required basis. Conclusions: Nurses need to be aware of the effectiveness and use of these medications so that patients can make informed treatment choices and develop a greater understanding of the importance of concordance with prescriptions.
Cavity wounds management: a multicentre pilot study
Authors: Meaume Sylvie , Facy Olivier , Munoz-Bongrand Nicolas , Ribemont Annie-Claude , Sigal Michèle-Léa , Couffinhal Jean-Claude , Trial Chloë , Tacca Olivier , Bohbot Serge 
Published: May 2014

The objective of this study was to assess acceptability (based on pain at removal), efficacy and tolerance of an absorbent and cohesive rope (UrgoClean Rope, Laboratoires Urgo) in the local management of deep cavity wounds. This study was a prospective, multicentre (13), non-comparative clinical study. Patients presenting with an acute or chronic non-infected cavity wound were followed up for four weeks and assessed weekly with a physical examination, in addition to volumetric, planimetric and photographic evaluations. Pain at removal was the primary criterion, assessed on a Visual Analogic Scale. The percentage of the wound surface area reduction and volumetric reduction were considered as secondary efficacy criteria. Forty three patients were included in this study. After one week of treatment dressing removal was painless and continued to be so throughout the period of the trial (four weeks). Median surface area at baseline was 7.74 cm2 and was reduced by 54.5% at week 4 (relative area reduction). Median wound volumetric value was noted 12 ml at baseline and was reduced by 72.7% by the end of treatment. The cohesiveness of the new rope was considered very good by health professionals. No residue was observed on the wound bed during the dressing change with the new rope. There were no adverse events related to the tested rope, during this trial. Pain-free removal associated with good efficacy and tolerance were observed with this new cohesive rope in the healing process of deep cavity wounds and could represent a therapeutic alternative to the usual ropes used in such indications.
Depression and malnutrition: how they interact in hospital patients
Authors: Alam Shakil , Sanchez-Crespo Jose , Vignaraja Raj , D’Souza Raymond 
Published: May 2014

Aim: Malnutrition and depression are prevalent in hospital patients, particularly the elderly. There is evidence to suggest an association exists between the two, with both malnutrition and depression co-existing in some patients. The aim of this study is to assess the association between nutritional status and depressive symptoms. Methods: Our study comprised 129 adult medical patients admitted to Chase Farm Hospital during the period of 15 August to 15 October 2009. Each individual's age and gender were noted, in addition to their nutritional status and incidence of depression, as assessed by the Liverpool Nutritional Score and PHQ-9 questionnaires respectively. Results: Six confused patients were excluded to avoid unreliable answers to the depression screening questionnaire. Of the 129 remaining patients, the mean age was 80.2 years; 60% were male and 40% female. Malnutrition was identified in 54% (n=70) and depression in 46.5% (n=60) of the sample. Of the malnourished patients, a total of 56.5% (n=40) were depressed. Of the non-malnourished patients only 15.2% (n=9) were found to be depressed. Conclusions: Nutritional deficit presented a significant association with depression. In patients suffering from one of these problems, this should prompt screening for the other. Further research is needed to analyse the direction of causation in this relationship: is depression a risk factor for malnutrition, is the converse true, or does another variable underpin both?
Different expectations can lead to confusion about the school nurse’s role
Authors: Stockman Tina R 
Published: May 2014

Aim: To gain qualitative information on the perceptions and expectations of the school nurse’s role in Scotland. Method: Information was gathered using a short questionnaire aimed at educationalists, health professionals and families. Data were analysed using role theory. Results: The results indicate that the reference groups had very different expectations of school nurses. Conclusions: Communication between the reference groups concerning interpretation and implementation of new professional guidelines on health and education services is a difficult and contentious issue and there is a pressing need for more clarity over the role of school nurses and efforts to increase public understanding of this role. Recommendations are made for future investigation and research.
‘HPV? Never heard of it’ Students and the HPV vaccine
Authors: Racktoo Sophie , Coverdale Gill 
Published: May 2014

Aim: Research was carried out to explore the knowledge and attitudes regarding HPV and the HPV vaccine among 12–13-year-old girls. Method: The research used four focus groups of school-aged girls. The ‘framework analysis approach’ (Krueger, 1994) was used for data analysis. Results: Five key recurring themes were identified: knowledge about HPV, concerns about the HPV vaccine, acceptability of the vaccination programme, media coverage affecting attitudes towards cervical cancer and the HPV vaccine, information about HPV and the HPV vaccine. Conclusions: This study concluded that the HPV vaccination programme has been successful in promoting a positive attitude to its value. However, information about HPV and the HPV vaccine must be communicated to girls and their parents using creative methods relevant to the target population.
Looking at the potential impact and management of acne
Authors: Watkins Jean 
Published: May 2014

Acne is a common skin condition in adolescents and young adults. Severe cases can lead to scarring if left untreated. The condition can also have a substantial impact on young people's self-esteem and emotional health and wellbeing. School nurses can help support young people with acne by providing advice on the condition and its treatment, and through referral when appropriate.
Attention deficit hyperactivity disorder (ADHD) part two: evaluation and intervention
Authors: Chu Sidney 
Published: May 2014

Part one of this article focused on the diagnosis of attention deficit hyperactivity disorder (ADHD) as a specific childhood disorder. The evaluation and diagnosis of this complex disorder requires a team approach by using a multidimensional formulation. The management and treatment of children with ADHD has challenged different medical, psychological, educational and therapy professionals over the last 3 decades. In part two of this article, information related to evidence-based evaluation and intervention procedures provided by a multidisciplinary team is synthesized by integrating information from different research studies.
Principles and contemporary management of anal fistulas
Authors: Hammond TM , Lunniss PJ 
Published: May 2014

Anal fistulas are chronic pathological connections between the anal canal and perineal skin. By either persistently discharging or intermittently occluding, causing recurrent abscess formation, they can significantly impact on the lives of those afflicted. Anal fistulas often pass through the anal sphincter complex, responsible for maintaining continence to rectal contents (gas, liquid or solid stool); therefore, treatment is aimed not only at fistula eradication but also at preserving sphincteric function. To date, fistulotomy remains the most effective way of eradicating the pathology, but division of those sphincter muscle fibres enclosed by the tract renders the patient at risk of incontinence. For those in whom fistulotomy is not recommended, alternative strategies exist, including techniques aimed at minimizing sphincter disruption, ′sphincter−conserving′ methods or the placement of a long−term loose draining seton. This article reviews the literature on all aspects of anal fistulas, and hopefully provides the reader with an insight to their potential complexity, the consequent difficulties in their management and the requirements of postoperative care.
Anaesthesia for the super-morbidly obese: a role for specialist centres?
Authors: Craig James , Dering Andrew 
Published: May 2014

Morbid obesity is growing in prevalence in the UK. In 1999, 0.8% of men and 1.8% of women, approximately 650000 people in total, were morbidly obese (body mass index (BMI) >40kg/m2). The associated increase in morbidity and mortality has led the UK government to sponsor several organizations to tackle obesity, including the National Audit Office (2001). In keeping with the Department of Health advocating specialist centres to manage morbidly obese patients, the authors believe these or similar centres should manage the even more challenging super-morbidly obese (SMO) patients (BMI >50kg/m2) during surgical episodes.
Painful swollen legs in a diabetic patient
Authors: Neill Johanne 
Published: May 2014

A 52-year-old man presented with a 6-week history of bilateral painful thighs and reduced mobility. Glycaemic control of his type 2 diabetes of 25 years' duration was poor and he had recently commenced on insulin. His disease was complicated by retinopathy, peripheral neuropathy and nephropathy. He denied trauma to the legs. The thighs were swollen with pitting oedema extending from the ankles. There was no erythema or temperature disparity. The thighs were exquisitely tender on palpation of the anterior muscle compartment. Both calves were also tender to palpate. No mass was identified. The peripheral pulses were intact and the upper limbs were entirely normal. Haematological investigations revealed erythrocyte sedimentation rate 136 mm/hr, C reactive protein 13 mg/dl, normal white cell indices and normal coagulation profile. On biochemical analysis urea and creatinine were elevated; creatine kinase was increased at 250 U/litre. Glycosylated haemoglobin was 14%. All immunological and vasculitic profiles were normal. Urinary protein excretion was 12 000 mg/24 hours. This man was admitted for investigations, rest and rigorous control of his diabetes. He underwent ultrasound Doppler of his legs ruling out deep venous thrombosis or insufficiency of the large arteries. A computed tomography scan of the thighs revealed diffuse inflammation of the right thigh musculature. Nuclear bone scan confirmed increased uptake in the muscles but no bony abnormality. Magnetic resonance imaging was the definitive investigation showing diffuse enhancement on T2 weighted images of the anterior muscle compartment of the right thigh (vastus intermedius and vastus lateralis) with lesser changes noted in the left thigh and both calves (soleus) (Figure 1). A focal area of nonenhancement in the right rectus femoris following administration of gadolinium was consistent with an area of infarction (Figure 2). An open biopsy specimen showed non-specific inflammation and regenerating muscle fibres. Occasional necrotic muscle fibres were remarked upon. No haemorrhage was noted and the intramuscular blood vessels were normal. The diagnosis of diabetic muscle infarction was made. After 1 month of rest, analgesia and good glycaemic control the swelling and pain had completely resolved. A similar episode affecting the left thigh some months previously was reported. He is the only recorded patient to have had involvement of both thighs and calves bilaterally in the same episode.
Diagnosing multiple sclerosis: expect the unexpected
Authors: Ramtahal J , Larner AJ 
Published: May 2014

A previously healthy 41-year-old Hong Kong Chinese man, who emigrated to the UK at the age of 20 years, presented with a complaint of visual blurring and of painless double vision but without directional selectivity. Ophthalmological assessment found normal visual acuity, colour vision, visual fields, and pupillary reactions; examining eye movements there was a left hypertropia, with weak left inferior rectus on Hess chart. A diagnosis of acute partial pupil-sparing left oculomotor (third) nerve palsy was made. Symptoms resolved spontaneously within 2 weeks, but magnetic resonance brain imaging arranged at the initial consultation showed multiple high signal intensity lesions in the white matter of the cerebral hemispheres periventricularly and in the corpus callosum, suggestive of demyelination, although no brainstem lesions were noted. When subsequently seen in the neurology clinic, the patient was asymptomatic and there were no neurological or neuro-ophthalmological signs. Serum angiotensinconverting enzyme level and chest X-ray were both normal. Interval magnetic resonance brain imaging 7 months later showed no new changes, and since the patient was asymptomatic he declined further investigation or follow up. Five years later, the patient presented again with a complaint of double vision without directional selectivity. Signs were now of a right abducens (sixth) nerve palsy, without any other neurological or neuro-ophthalmological signs. Symptoms resolved spontaneously after 4 months. Magnetic resonance brain imaging again showed multiple high signal lesions in the periventricular white matter and corpus callosum, but no brainstem or cerebellar lesions were seen. Pattern shift visual evoked potentials were within normal limits, providing no evidence for a demyelinating optic neuropathy. The patient agreed to lumbar puncture, and CSF analysis showed normal protein, glucose, cell count, angiotensin-converting enzyme level, and cytology, but oligoclonal bands were present in a type 2 pattern consistent with a diagnosis of multiple sclerosis.
Fatal avulsion of inferior vena cava following blunt abdominal trauma
Authors: Bourkiza R , Hegade V , Menon J 
Published: May 2014

A 25-year-old woman was brought in by ambulance to the accident and emergency department following a road traffic accident where the car hit a tree at 70 miles/hour. At the scene, her Glasgow Coma Score was 9/15 and her blood pressure was 94/64 mmHg, for which she was fluid resuscitated. On arrival at accident and emergency, she was conscious and maintaining her airways. Although she was complaining of abdominal and back pain, there was no external haemorrhage. Secondary survey showed rigid abdomen with guarding. Trauma series showed stable cervical spine and pelvis, with no evidence of rib fractures or blunt trauma to the chest. Computed tomography of her chest and abdomen revealed pulmonary contusion with a small right pneumothorax. The right atrium, right ventricle and inferior vena cava appeared compressed and no obvious leakage could be seen in the pleural or pericardial space (Figures 1–3).The patient deteriorated haemodynamically and was immediately taken to the operating theatre. On laparotomy more than 3 litres of blood was found, and as soon as the tamponade was released, the patient sustained cardiac arrest. With ongoing resuscitation, the laparotomy was extended as a left anterolateral thoracotomy, to cross clamp the descending aorta and to perform open cardiac massage after opening the pericardium. The abdomen was packed with four quadrant packs. Despite transfusion of 13 units of blood and ten cycles of cardiopulmonary resuscitation the patient died. On removing the abdominal packs, the retrohepatic inferior vena cava was found to be completely transected.
Thyroid abscess: an unusual case secondary to biliary sepsis
Authors: Mathew John , Goodfellow Peter , Chadwick David R 
Published: May 2014

An 82-year-old man was admitted to the surgical ward as an emergency with clinical features suggestive of acute cholecystitis. At the time of admission, his temperature was 37.1°C. Laboratory tests showed a white cell count (WCC) of 11.6 × 109/litre, a C-reactive protein (CRP) of 14 mg/litre and altered liver functions (bilirubin 25 μmol/litre, alkaline phosphatase 336 iu/litre). The rest of the haematological and biochemical investigations were normal. He had a coexisting goitre that had been present for over 60 years. He was clinically and biochemically euthyroid with a free thyroxine of 17.1 pmol/litre and a thyroid-stimulating hormone of 0.27 mU/litre. Ultrasound scan of the abdomen showed calculous cholecystitis, and the rest of the scan showed nothing else of significance. The patient was started on broad-spectrum antibiotics. His condition deteriorated in the next 48–72 hours with features of systemic sepsis. Abdominal examination did not show any evidence of clinical deterioration. At about the same time he was noted to have erythema and tenderness over his goitre with a slight increase in size (Figure 1). There was no evidence of any pressure symptoms. The inflammatory markers started to rise (WCC = 16.2 × 109/litre, CRP = 108 mg/litre). Blood culture was performed after the initiation of antibiotic therapy, and was found to be negative. Because of the large size of the goitre and clinical evidence of retrosternal extension a computed tomography scan of the neck was done rather than an ultrasound scan (Figure 2). Abscess of the thyroid was suspected and an attempt was made to aspirate, but this had to be abandoned as the pus was very thick. The thyroid was explored through a classical transverse incision and its capsule incised. A large quantity of pus and degenerative thyroid tissue was removed, and a corrugated rubber drain was left in place for drainage. The culture of the thyroid contents grew Klebsiella, sensitive to third generation cephalosporins. The patient was placed on cefuroxime for 7 more days, following which he made a gradual and uncomplicated postoperative recovery (Figure 3).