bluuebunny/crossref_metadata_2025_split huggingface dataset:
A diagnosis not to miss
Authors: Garside Maria , James Rebecca , Cooper Nicola 
Published: May 2014

A 45-year-old woman attended accident and emergency after fainting and feeling unwell with a fever. Blood and protein were noted in the urine. A diagnosis of urinary tract infection was made and she was sent home with antibiotics. She became increasingly unwell with fever, headache and confusion before collapsing the following day. On examination her Glasgow Coma Score was 7/15, with a fever of 38.2° C, respiratory rate of 35/minute, pulse of 120/minute and blood pressure of 160/95 mmHg. She had a widespread petechial rash. Tone was increased in all four limbs and she had extensor plantar responses. There was no neck stiffness. Her pupils were equal and reactive, but her gaze deviated to the right. Soon afterwards she had a focal fit involving the left side of her body. Her blood results were: sodium 142 mmol/litre, potassium 2.8 mmol/litre, urea 9.1 mmol/litre (blood urea nitrogen 25.3 mg/dl), creatinine 120 mmol/litre (1.44 mg/dl), glucose 12.5 mmol/litre (208 mg/dl), haemoglobin 7.7 g/dl, total white cells 21.8 × 109/litre (neutrophils 14.2 × 109/litre), platelets 8 × 109/litre. Arterial blood gases and coagulation studies were normal. A contrast computed tomography scan of the brain, performed under general anaesthesia, was normal.
The necessity of 2-hour pre-operative fasting for patients
Authors: Mclauchlan Rita , Patton Niall 
Published: May 2014

Aim: The paper discusses the findings of an audit carried out at Manchester Royal Eye Hospital. Its focus was to explore whether it was necessary for patients to fast 2 hours prior to undergoing surgery (including vitreoretinal) under local anaesthetic.A total of 67 patients were included in the audit (27 female (40%), 40 male (60%)}. Results: Average age was 68 years (range 31-98 years). 60/67 had sub-Tenon's local anaesthetic (90%), 5/67 (7.5%) had peribulbar anaesthetic and 2/67 (3%) had topical anaesthetic. Results show that over an 8 month window of prospective audit on vitreoretinal patients who had undergone surgery for a variety of indications and with different diagnoses typical of a tertiary vitreoretinal service, both by retinal fellows and consultants, with a time on average of over an hour per case, there were no reported clinical incidences 0/67 (0%) that were either caused by a lack of fasting, or exacerbated by a lack of fasting. Discussion: As a result of this audit we recommended that for all patients undergoing local anaesthetic (excluding sedation) vitreoretinal procedures, and because cataract surgery is usually of a significantly shorter duration, fasting for 2 hours is unnecessary. The standard for best practice policy is now embedded in practice within the ophthalmic division in Central Manchester Foundation Trust.
Nurse practitioner management of patients with retained contact lens
Authors: Gwenhure Tendai , Gibbons Helen 
Published: May 2014

Attendance to the ophthalmic accident and emergency department with a retained contact lens is not uncommon. The patient's management involves thorough assessment, examination, treatment and health education. This article provides an overview of the assessment, diagnosis and management of patients presenting to the ophthalmic accident and emergency department with retained contact lenses. Case presentations will be used to analyze causes, signs and symptoms and treatment modalities for retained contact lenses. The nurse's attention is drawn towards: Significance of a comprehensive history and visual acuity assessment Recognition of clinical signs and symptoms Full anterior segment examination Importance of lid eversion and subtarsal examination Treatment modalities Health promotion.
Correspondence
Authors: Notta Hardev 
Published: May 2014

Dear Editor Randhawa et al’s article, Communication in the development of culturally competent palliative care services in the UK: a case study (2003) is well written and informative for professionals working in palliative and health care. It confirms the observations of Hill and Penso (1995) that communication is a major issue in providing adequate palliative care services to minority ethnic groups. However, in 1995 when the research was done, Acorns Children’s Hospice was already providing an adequate palliative care service to minority ethnic groups, which it has done since 1988, and therefore there may well be other hospices doing so.
Barriers to effective uptake of cancer screening among black and minority ethnic groups
Authors: Thomas Veronica Nicky , Saleem Tariq , Abraham Rachel 
Published: May 2014

Aim To describe some of the factors that act as barriers to effective uptake of breast and cervical cancer screening services among black minority ethnic (BME) groups living in Brent and Harrow in the UK. Design A series of focus groups among African Caribbean, African, Gujarati, Pakistani, Greek and Arabic groups were held to discover their perceptions of cancer screening, the barriers to effective uptake and some strategies for intervention. Sample This consisted of 135 participants: 85 women and 50 men. Results Analysis of focus group data has revealed poor knowledge, underlying health and cultural beliefs, attitudes, language and unhelpful attitudes of health professionals to be important barriers. In terms of strategies for effective intervention, the most popular strategy for improving uptake of screening services was community-based cancer awareness education that is sensitive to religious and cultural needs. Conclusion There is a need to provide community-based education to increase the uptake of screening services among BME groups. It is essential to plan concurrently to educate GPs and other health professionals in cultural beliefs and customs, language needs, racial awareness and communication skills.
Evaluation of a pilot nurse-led, community-based treatment programme for lymphoedema
Authors: Howell Doris , Watson Marcia 
Published: May 2014

Aim To evaluate the effect of this treatment programme on lymphoedema specific fluid volume, pain, discomfort, limb function and quality of life outcomes. Design Prospective, descriptive study. Sample and Setting A convenience sample of four women with breast-cancer related lymphoedema referred to a community-based specialist oncology nurse consultant programme in Canada that involved manual lymph drainage combined with compression bandaging. Measures Circumferential arm measurements to assess fluid volume, visual analogue scales to assess the impact of lymphoedema on specific practical, physical and psychosocial problems known to be affected by lymphoedema and field notes. Results Although a reduction in arm volume was observed, quality-of-life outcomes worsened for most of the women as they realized that this symptom would require life-long management, serving as a reminder of their breast cancer experience. Conclusions Lymphoedema treatment programmes must ensure that the multidimensional impact of this symptom on women’s lives is recognized and addressed as part of the treatment process.
Exploring students’ experience of training for counselling skills and the impact on practice
Authors: Johnston Bridget , Smith Val 
Published: May 2014

Aim The aim of this study was to explore participants’ experience of an accredited counselling skills course and their perception of its impact on practice. Design A qualitative design was used utilizing a mixed-method approach. Data were collected using semistructured interviews and the repertory-grid technique. Data were analysed using thematic content analysis (interviews) and the repertory grids were analysed qualitatively using a four-stage procedure. Sample A convenience sample of six healthcare professionals undertaking a counselling skills course completed both interviews. Results The biggest impact of the course was in the area of self-awareness and skill development. The development of attentive listening, both in terms of objective and subjective findings, was evident. Students perceived that personal qualities, such as warmth and caring, were essential. All participants identified that the group were supportive and that this enhanced learning. The students changed their practice by improving their skills, increasing their awareness and by developing deeper therapeutic relationships with patients and their carers. Conclusion This research adds to the body of knowledge in palliative care. It identifies key elements in the learning of counselling skills and recognizes the impact of these skills on improving the care of palliative care patients and families.
Authentic performance appraisal: when home is the workplace
Authors: O’Connor Margaret , Lee Susan 
Published: May 2014

Home care services have characteristics that are distinctive from other health care settings. Thus, they require different management systems to those traditionally used in institutional settings. Typical management models often require adaptation for home care services in areas such as staffing, education and support. This includes performance appraisal, where traditional models may be inappropriate when clinicians work alone, with little supervision. This article describes an experience of adapting a performance appraisal tool, in order to be more relevant for staff working in home-based care. The project arose from staff frustration with the expectation of management that a tool developed for institutional settings would be appropriate for the home setting. This frustration gave the impetus for developing a successful appraisal system, and because of staff involvement, the model was wholeheartedly embraced. The process of development is discussed, and the model explained, with commentary about its implementation in a home care service.
An inner struggle for hope: insights from the diaries of bereaved family caregivers
Authors: Holtslander Lorraine , Duggleby Wendy 
Published: May 2014

Aim: To explore the experience of hope for bereaved palliative caregivers through participant hope diaries. Design: A secondary analysis of hope diaries collected as part of a grounded theory study of hope and bereavement. Sample and setting: Twelve older women from a small Canadian city completed a hope diary. Data analysis: Content analysis (Patton, 2002) was applied to describe and interpret the data. Findings: Hope was a feeling of peace, courage, strength, and self-confidence that enabled them to face each day and look to the future with a positive outlook. Hindrances to hope were multiple losses, loneliness, and physical health concerns, which created an inner struggle for hope. Hope was fostered through positive thoughts, connections, and taking care. Writing in the diary affected their experience of hope. Conclusion: The diaries provide unique insight into their experience, suggesting practical ways to foster hope in bereavement.
Spiritual support interventions in nursing care for patients suffering death anxiety in the final phase of life
Authors: Kisvetrová Helena , Klugar Miloslav , Kabelka Ladislav 
Published: May 2014

Purpose: To investigate which activities from the ‘Spiritual Support’ intervention of the Nursing Interventions Classification (NIC) are used in patients with the nursing diagnosis ‘Death Anxiety’ in the Czech Republic, and which activities could feasibly be implemented into practice.Method: The study surveyed 468 Czech nurses using a quantitative questionnaire with Likert scales.Results: The most frequently used activity was ‘Treat individual with dignity and respect’ and the least frequently used was ‘Pray with the individual’. ‘Treat individual with dignity and respect’ was also thought to be the most feasible activity for Czech nursing practice. Significant differences were found between nurses working in hospices and those in other sites and between religious believers and non-believers.Conclusion: Even in the secularised Czech Republic, nurses can make use of the NIC Spiritual Support intervention in end-of-life care.
Complementary therapy: perceptions of older people with lung or colorectal cancer
Authors: Roulston Audrey , Wilkinson Pauline , Haynes Tommy , Campbell Jim 
Published: May 2014

Aim: To explore how older people with lung and colorectal cancer view registered complementary therapy (CT) services in Northern Ireland. Background: A literature review highlighted gaps around information, access, and communication between patients and health professionals regarding CT services. Methods: Using structured interviews, a survey of 68 patients in one hospital and one hospice was conducted in Belfast, Northern Ireland. Results: All respondents felt that CT services should be better promoted and more easily accessible to older people with cancer. Some patients were concerned about the lack of written information provided regarding CT services, which they believed led to poorer uptake and uncertainty regarding the potential benefits. Others were concerned that engaging in or disclosing CT usage might negatively affect existing relationships with medical professionals. Conclusion: Patients should be offered high quality written information on CT services to enable choice, improve knowledge, and promote wider access. Increased physician education may facilitate provision of such information.
Partnerships in mental health: addressing barriers to social inclusion
Authors: Russell Anneliese , Lloyd Chris 
Published: May 2014

Current trends in mental health services emphasize working in partnership with consumers and other government and non-government community organizations for improvement in quality of life for service users. People with a mental illness experience social exclusion, thereby limiting their ability to participate fully in community life. Occupational therapists have a substantial role to play in helping service users to overcome barriers to their community inclusion. Partnerships need to be formed to increase access to community resources and participation in activities that are enjoyed by other members of the community. Such partnerships have a health promotion emphasis and foster the relationship between mental-health services and the wider community, thus shifting the focus from direct occupational therapy service delivery to community-based rehabilitation interventions. This article describes the development, implementation and evaluation of an Australian healthy lifestyle course devised to meet the identified rehabilitation goals of people with mental illness to lose weight, get fit, commence vocational study and get a job. The course was run in partnership between mental health consumers, occupational therapists from the St George Mental Health Rehabilitation Service and staff and students from the Sutherland College of Technical and Further Education.
Effects of a resistance exercise programme on the performance of inactive older adults
Authors: Kalapotharakos VI , Michalopoulou M , Tokmakidis S , Godolias G , Strimpakos N , Karteroliotis K 
Published: May 2014

Although published studies have indicated the effectiveness of strength exercise for improving muscle strength and functional and neuromotor performance in older adults, there is limited evidence concerning the effects and the intensity of a resistance exercise programme. This study aimed to evaluate the effects of a 12-week high- and moderate-resistance exercise programme on functional and neuromotor performance in healthy, inactive older adults. In total, 33 sedentary people (aged 60–74years) were assigned to one of three groups: control; high resistance exercise; and moderate resistance exercise. All three groups were evaluated in the pre- and post-exercise period using the 6-minute walk test, whole body reaction time and one leg stance time. After the exercise period, both resistance exercise groups significantly improved their lower body strength, functional performance (as measured by the 6-minute walk test), whole body reaction time and one leg stance time. Functional and neuromotor performance improved similarly for both high- and moderate-resistance exercise after the training period. The high-resistance exercise was more effective in increasing the lower body strength than moderate-resistance exercise. Results suggest that functional and neuromotor performance can be significantly improved with both high- and moderate-resistance exercise protocols.
A practical guide to the provision of mattresses and cushions to relieve pressure
Authors: Collins Fiona 
Published: May 2014

Pressure damage is largely preventable, but if allowed to develop, individuals have the potential to suffer pain, indignity and even death. Pressure-relieving equipment is available to people at risk of pressure damage. Selection of suitable support surfaces must be based on identified criteria following holistic assessment. This article aims to provide the reader with a general guide to the provision of pressure-relieving support surfaces. As pressure damage can occur both in the bed and the chair, the qualities of both mattresses and cushions will be discussed.
Effects of dynamic ankle-foot orthoses on standing in children with severe spastic diplegia
Authors: Nslund Annika , Jesinkey Kristina , Hirschfeld Helga , von Wendt Lennart , Sundelin Gunnevi 
Published: May 2014

The aim of this study was to investigate whether wearing a dynamic ankle-foot orthosis (DAFO) improved standing posture in six children with severe spastic diplegia. Kinematics and ground reaction forces were recorded with a three-dimensional optoelectronic movement analysis system and two force plates.The results revealed that on a group level, DAFOs did not improve standing posture, distribution of body weight or lateral standing stability as reflected in the horizontal ground reaction forces. However, some children could benefit from the use of a DAFO through a more equal weight distribution and improved sagittal position of the knee, compared to wearing shoes alone. According to the heterogeneous clinical signs and symptoms in children with severe spastic diplegia, studies on a group level easily lead to negative findings and therefore individual benefits could be showed by using single case designs.
Canadian therapists' experiences of community-based rehabilitation services
Authors: Hollis Vivien , Madill Helen , Darrah Johanna , Warren Sharon , Rivard Annette 
Published: May 2014

Health policy and demographic trends have produced considerable changes to the delivery of health care in recent years. This focus group study conducted in Alberta and Saskatchewan, Canada, involved 49 occupational therapists and physical therapists who discussed their experiences of current health services in relation to rehabilitation practice. Therapists' experiences were that regional rehabilitation service provision was variable and that there were client groups that gained from the shift to community-based rehabilitation and those that did not. Therapists reported changes to occupational therapy and physical therapy practice, including an increased focus on assessments, but fewer interventions being carried out and limited input into the provision of services to support clients in maintaining their health. The findings will be of interest to all practitioners and service providers.
Physiotherapy assessment of knee proprioception following stroke
Authors: Piriyaprasarth Pagamas , Morris Meg , Winter Adele , Paratz Jennifer 
Published: May 2014

This survey investigates methods used by physiotherapists to assess knee proprioception in stroke patients. Five hundred and seventeen Australian physiotherapists were surveyed using a 12-item survey with 326 surveys returned (63% response rate). Work experience ranged from less than 2 years to more than 20 years. Most physiotherapists assessed both joint position sense and joint movement sense in supine (43.1%), followed by sitting (26.1%) and standing (17.0%). Proprioception at the knee, toe, ankle and hip were measured with the largest proportion of assessments involving the knee joint (38.2%). Testing typically required patients to have their eyes closed, to respond verbally to the direction of movement, to match the position of a joint, as well as to copy movements of the affected limb with the unaffected limb.Most physiotherapists passively moved the patients' joints for the static and dynamic tests. Three to ten repetitions of each test were used with five repetitions most often chosen.
Background to the post-acute care trial of community hospital rehabilitation for older people
Authors: Green John , Young John , Forster Anne 
Published: May 2014

The post-acute care trial of community hospitals (PATCH) study is a multicentre, randomized controlled trial (RCT) comparing outcomes of rehabilitation for older people provided in five district general hospitals (DGHs) and seven associated community hospitals (CHs) in urban and rural settings. This article describes the background to the PATCH study, compares the characteristics of the participating DGHs and CHs and describes the participating patients. Descriptions of the DGHs and CHs were produced from information obtained from each centre. Recruitment rates, patient characteristics and hospital stays were compared between centres. There was variation in operational policies of the DGHs and in the organizational features of the CHs, such that patient characteristics and lengths of hospital stay differed between centres. Statistical comparisons suggested that these differences were not systematically distributed. This underpinning study to the PATCH RCT suggests that the variation in study sites and patient characteristics is sufficient to allow generalizable statements about outcomes of CH and DGH rehabilitation care of older people.
Do aqua-aerobics improve gait and balance in older people? A pilot study
Authors: Waters Debra , Hale Leigh 
Published: May 2014

Research suggests that aqua-aerobics improves aerobic and muscular capacity of older persons, however, few studies have measured changes in gait and balance with aqua-aerobic activity. In this pilot study, eleven healthy males and females (70.55 ± 3.6 years) participated in a twiceweekly, 12-week aqua-aerobics programme. Measures of gait and balance, physical activity, mobility history and health-related factors were obtained. The step test—a reliable test of dynamic balance—significantly improved (P = 0.005) following the programme. In addition, participants reported a range of perceived psychological and physical benefits.
Changing practice for acute hemiplegic shoulder care: A best practice model
Authors: Nicks Rebecca J , DeGruyter Melissa A , Walkenhorst-Maccanti Heidi , Bernhardt Julie 
Published: May 2014

This study evaluates the implementation of a best practice management model for hemiplegic shoulder care in acute neurological patients. Following a three-month trial, an existing model was modified and implemented on the neurosciences ward. Sixty-five patient records were randomly audited to evaluate implementation. Of these, 30 (46%) had signs that indicated use of the model, and of these, the model was used for 28 (93%). Following implementation, the use of outcome measures increased from 25% to 94%, and the consistency of management for the hemiplegic shoulder improved from 69% to 97%. The management tool for acute hemiplegic shoulder encourages timely identification of risk in patients with upper limb hemiplegia, assists clinicians to prioritize their time and appropriately allocate resources according to best practice.