bluuebunny/crossref_metadata_2025_split huggingface dataset:
FOOT CARE EDUCATION IN RENAL PATIENTS WITH DIABETES
Authors: Lawrence A. 
Published: July 2012

SUMMARYFoot complications are said to be the primary cause of hospitalization for patients with diabetes, resulting in enormous personal and financial costs. It is reported that end‐stage renal disease (ESRD) diabetic patients with peripheral vascular disease have a much higher incidence of foot complications and increased risk for amputation. However, despite the serious financial burden caused by diabetic foot ulcers and their complications, the importance of diabetic foot care is still not fully recognised or supported.There is increasing evidence to suggest that education on foot care is essential for patients with diabetes. Studies have shown that simple techniques such as identifying those at risk of developing foot ulcers, educating patients about foot care that is tailored to meet the requirements of individual patient needs, educational background and learning ability can be of obvious benefit to people with diabetes and is cost‐effective.
TRANSPLANT STRATEGIES FOR DIABETIC RENAL PATIENTS
Authors: Belmonte Amado Andrés 
Published: July 2012

SUMMARYThe strict control of glycaemia in the diabetic patient prevents severe long‐term complications of diabetes. The most effective physiological method to control glycaemia in the type 1 diabetes patient is pancreas or pancreatic islet transplant. However, these types of transplants require chronic immunosuppressant treatment that leads to short and long term complications and are reserved for type 1 diabetic patients with life threatening complications (frequent unexplained ketoacidosis or hypoglycaemias). With regards to type 1 diabetics with end‐stage nephropathy, simultaneous pancreas‐kidney transplant has excellent results and makes it possible for the patient to be insulin and dialysis free. If vascular complications, especially coronary disease, make it impossible to perform a simultaneous pancreas‐kidney transplant, kidney transplant alone will be indicated and, in the future, the patient may have access to the transplant of pancreatic islets when the technique is perfected. Type 1 diabetic patients who receive a living or cadaver kidney transplant, and later a pancreatic transplant show excellent results. Type 2 diabetics, in whom pancreas transplant is not indicated, as they do not have a total deficit of insulin, can have access to a kidney transplant if they reach end‐stage nephropathy in spite of their more advanced age, as long as their vascular disease allows it. Transplant of cadaver islets is beginning to provide good results, thanks to new immunosuppressant protocols. This procedure does not require surgery, the islets being implanted into the liver by infusion through the vena porta. Obtaining islets from embryonic or adult tissue stem cells, although in an experimental phase, could be a reality in the near future.
DIABETIC NEPHROPATHY ‐ WHO CARES?
Authors: Wilde C. 
Published: July 2012

SUMMARYDiabetic nephropathy has become the most common single cause of Established Renal Failure (ERF) in the United States of America (USA) and Europe. In the United Kingdom (UK) diabetic nephropathy is seen in 18% of new patients requiring dialysis (1). In the USA 7.3% of all adults and 17.8% of those over 65 years have diabetes mellitus (2). Furthermore diabetic nephropathy is the cause of ERF in up to 45% of patients on dialysis (3). Recently compiled data by the World Health Organisation (WHO) shows that approximately 150 million people worldwide have diabetes and predict that this number may well have doubled to 300 million by 2025 (4). These figures are clearly daunting and renal units must prepare themselves for the rising number of patients with diabetes needing renal replacement therapy (RRT) in the future.Renal specialist nurses do not always have a major role to play in the prevention of diabetic nephropathy. Their remit must be to try and delay the progression to ERF and perhaps more importantly to concentrate their efforts on their ERF patient population with diabetes that have co‐existing diabetes related pathologies. This article will attempt to discuss how renal nurses can best expand/extend their skills and knowledge to provide effective care for this patient group, and explore whether developing new and innovative roles or just new ways of working is the way forward.
THE DEVELOPING ROLE OF THE RENAL DIABETES NURSE
Authors: Youngman S. 
Published: July 2012

SUMMARYDiabetes as a chronic disease is often complicated in its management, particularly when combined with chronic and end‐stage renal failure. Patients, carers and health care professionals are unfortunately often confused by either too little or conflicting advice provided by the two specialist teams. Within this context, the Renal Diabetes Nurse (RDN) role serves to bridge the gap by ensuring effective links and communication.Currently, renal referrals are made from surrounding secondary care settings and primary care GP practices. The expansion of renal outreach clinics, the appointment of new consultant nephrologists and the emergence of nurse‐led clinics, reflects our continuous growth to meet the demand for renal services.The number of patients with renal failure and diabetes is set to increase as the acceptance criteria are clarified and referral routes made explicit. An ageing population (1) with 21–62% of the renal population over the age of 65 (depending on the location of the renal unit), coupled with an increase in the Asian and African‐Caribbean population all contribute to increased patient numbers (2). It is now well recognised that these patients often experience associated generalised atheroma and vascular calcification from inadequately managed hypertension and diabetes over a number of years. Consequently, this group of patients are often “high maintenance” requiring input from the multidisciplinary team on a continuing basis.
THE CHALLENGE OF KIDNEY TRANSPLANTATION AMONG MINORITY ETHNIC GROUPS IN THE UK
Authors: Randhawa G. 
Published: July 2012

SUMMARYThe increased rate of renal failure secondary to diabetes among minority ethnic groups compared to Caucasians in the UK has been well documented. However, the impact of this phenomenon on kidney transplant services has been relatively unexplored. The Government has recently published its ‘Tackling Health Inequalities: A Programme for Action’ report which emphasises the importance of reducing health inequalities at all levels of the health service. This article provides a timely review of the UK's national transplant database examining the provision of kidney transplant services to minority ethnic groups in the United Kingdom. It seeks to explore the demographics of the database by focusing upon waiting list data, donor data, and recipient data. Inequalities do currently exist in transplant services and the solutions to rectifying this situation are complex. However, the financial and human burden of not addressing these inequalities encourages some immediate action.
PUBLIC AWARENESS AND ACCEPTANCE OF TISSUE AND ORGAN DONATION
Authors: Ozdag Nurten 
Published: July 2012

SUMMARYOrgan donation is a worldwide problem especially in developing countries due to lack of knowledge about brain death and organ transplantation as well as traditional values and beliefs. Limited data are available concerning public knowledge and awareness of organ donation and transplantation in Turkey.A prospective study was carried out and data (n=774) were gathered from a structured questionnaire. The results indicated that 96.6% of participants had heard of organ donation and transplantation, 91.8 % approved donation, and 59.2% would consider donating organs of their own. 62.6% were unaware of the donation law.As 81.7% of participants were interested in having more information on the issue, information booklets covering brain death, donation law and the organ donation process may increase donation of organs.
AN INVESTIGATION INTO STRESS LEVELS AMONGST RENAL NURSES
Authors: Murphy F. 
Published: July 2012

SUMMARYA qualitative study was designed to explore renal nurses' perception of stress within their unit. This study collected information from ten staff nurses through semi structured taped interviews. Using content analysis, interviews were coded and categories and themes were identified.Findings indicate that stress was derived from the following categories: job content, resource issues, professional concerns, professional working relationships, extrinsic factors, and coping mechanisms. The actual words of the nurses were included to provide depth and substance to the categories and themes.A discussion was held regarding the relationship of these findings to theory. These findings have implications for nursing practice, administration and education. Recommendations are also made for future studies.
OUR DILEMMA: THE SELF‐MARGINAL PEOPLE
Authors: Ho TM. , Cordovilla L. 
Published: July 2012

SUMMARYCultural diversity is nowadays a common phenomenon in most developed countries. Its impact is felt in daily life, as well as in health care settings.Hospital del Mar, due to its geographical location, receives some of the 34.7% of immigrants from a varied cultural background. Endeavours are made to promote cultural awareness among staff and to facilitate communication.However, a Spanish Gypsy group, albeit not immigrants, are by large the problematic cultural group.A questionnaire study was conducted to validate the difficulty in treating these Gypsies versus migrant patients. The questionnaire was distributed to different health care professionals in the hospital. The result is not surprising. The problems encountered with the migrant patients are mainly due to language barrier. Concerning these Gypsies who speak fluent Spanish, the problems are by far more extensive. These are often generated by their abiding cultural values, distinctive lifestyle, low educational level and rejection of the shared norms of the majority. Any attempt to encourage adherence to hospital rules are often futile as a result of the gypsies' negative attitudes. Staff have expressed occasional feelings of weariness when dealing with such situations.
PERCEPTIONS AND EXPERIENCES OF PRE‐DIALYSIS PATIENTS
Authors: Iles‐Smith H. 
Published: July 2012

SUMMARYThe literature shows that many complications including psychosocial, sexual and economic are associated with dialysis. However few studies have been conducted from the patients' perspective or have examined the pre‐dialysis phase of established renal failure. The aim of this qualitative study was to explore the perceptions and experiences of pre‐dialysis patients.Ten patients were interviewed, on one occasion, prior to starting dialysis. The interviews were conducted in a semi‐structured manner in accordance with pre‐defined interview topics. The findings of the study highlighted that participants had no clear expectations of dialysis treatment and generally expressed a sense of fatalism and lack of knowledge. This was highlighted by the main emergent theme, response to information. It became clear that most of the patients had received information, but had either misinterpreted, or been unable to absorb it. A number of specific issues including provision, quantity, interpretation and the timing of information appeared to be linked to the participants' inability to gain knowledge.These study findings highlight the importance of a patient centred, flexible education programme to enable patients to absorb and accurately interpret information.
ON‐LINE CLEARANCE MONITORING FOR BLOOD ACCESS MANAGEMENT
Authors: Mehmedović N. 
Published: July 2012

SUMMARYOn‐line Clearance Monitoring (OCM) provides frequent and precise information about urea clearance values during haemodialysis. In the case of blood access recirculation, it is presumed that urea clearance values on OCM would be lower and suspect to blood access malfunction.In order to check the relation between significantly lower urea clearance values and blood access recirculation, the Kt value (Clearance × time/min) for fifteen patients on OCM, including the patients with a low Kt/V in spite of their small urea distribution volume (V) was observed.Average urea clearance was calculated indirectly using Kt value (Kt/time in minutes = average clearance ml/min) and blood access recirculation tests performed using slow/stop flow two‐needle, three samples method (urea method). After comparison of the recirculation percentage to clearance value, positive correlation between high recirculation and clearance reduction was noted. OCM alongside detection of haemodialysis inefficiency is also a practical instrument for blood access management between regular monitoring. Lower OCM urea clearance values demonstrate a possible blood access problem that can be confirmed with another method. When an OCM urea clearance reading is decreased by more than 25%, undiscovered access recirculation can be suspected.
ANAEMIA AS AN EARLY PREDICTOR FOR DIABETIC RENAL DISEASE? A REVIEW OF THE LITERATURE
Authors: Balshaw‐Greer A. , Davies J. , Casey J. 
Published: July 2012

SUMMARYDiabetes is the leading cause of end‐stage renal disease in the western world and significant proportions of patients with diabetes mellitus develop renal complications. Anaemia is a key indicator of renal disease, and potentially may contribute to the pathogenesis of diabetes complications. Early correction of anaemia therefore has the potential to prevent or reverse other complications This review of the literature will examine anaemia in diabetic patients and seek to determine whether it is exclusive to diabetic nephropathy.
EVALUATING STAFF AND STUDENT EXPERIENCES OF MULTIDISCIPLINARY CONTINUOUS PROFESSIONAL DEVELOPMENT VIA DISTANCE‐LEARNING
Authors: Hurst J. 
Published: July 2012

SUMMARYContinuous professional development (CPD) in caring for people with kidney disease is limited in some regions of the UK and within Europe generally. This is compounded for all by limited resources for course fees and the lack of study leave granted away from the clinical area for full‐time courses. This is set against recommendations from National and European governments, and renal clinical guidelines concerning expectations of CPD and clinical competency levels of renal nurses (1–4). In the past renal practitioners have been trained in all areas of the renal speciality by Schools of Nursing linked to renal units based in large teaching hospitals. However, more recent changes in the structure of Health Care provision have led in some instances to a rationalising of post registration education delivery.
LIVING WITH A HAEMODIALYSIS MACHINE
Authors: Sadala M.L.A. , Lorençon M. 
Published: July 2012

AbstractThe aim of the present study was to describe the experience of patients undergoing haemodialysis starting from their own perception. A qualitative perspective using Merleau Ponty's Existential Phenomenology was considered to be the most appropriate methodology for this study. Fifteen patients were interviewed in a haemodialysis unit at a Brazilian teaching hospital. Interviews were based on the question ‘What does the experience of living with a haemodialysis machine mean?’ Convergences in speeches were grouped into three categories: the machine, improvement in quality of life, reflection on patients' experience. These findings show the existential reality patients experience. A haemodialysis machine dictates their lives: they have to accept strict rules controlled by a team of healthcare providers. They realize it has to be so and there is no way out. It is the only way to get some relief from the symptoms of the disease. The feeling is mostly acceptance of the condition. Healthcare providers' dedication is recognized. Some participants complain about painful procedures, others deny them, others fantasize the reality. An essential piece of information is the lack of future perspectives; few patients mentioned the possibility of a transplant or the possibility of carrying out their own care. The study may contribute in outlining new perspectives for nurses to understand the needs of patients undergoing haemodialysis. An approach accepting patients' views will probably bring awareness to patients as to the possibilities of helping with their own treatment.
A CLINIC TO PREVENT THE DETERIORATION OF RENAL INSUFFICIENCY
Authors: Brousseau A. 
Published: July 2012

SUMMARYPrevention in nephrology is only possible with the cooperation of patients and their families. The nurse plays a considerable role in working with patients and is a major player in the team, responsible for follow‐up of the patient, where the earliest interventions can help delay and sometimes avoid dialysis. The hypertension clinic is the beginning of a continuum until dialysis. This paper describes three clinics that are managed in the renal service and indicates how they contribute to offering optimal care to a renal population.
NUTRITIONAL STATUS AND HANDGRIP STRENGTH IN PRE‐DIALYSIS PATIENTS
Authors: Pagels A. , Heiwe S. , Hylander B. 
Published: July 2012

SUMMARYIntroduction and aim — Protein‐energy malnutrition (PEM) is a well‐known problem in the care of persons with chronic kidney disease (CKD). Continuous assessment of nutritional status (NS) is therefore recommended in dialysis care as well as in the care of pre dialysis patients. Subjective Global Assessment (SGA) is a multifactor, subjective method for assessment of a patients' NS. Reduced handgrip strength (HGS) is associated with PEM and considered to be a reliable nutritional parameter that reflects loss of muscle mass. The aim of this retrospective study was to analyse NS in pre dialysis patients with a focus on the significance of HGS.Patients and study design — In this retrospective study HGS and NS assessed by SGA in 112 pre dialytic individuals were analysed. The patients' mean Glomerular Filtration Rate (GFR) was 14 (±4) ml/min. and their mean age was 63 (±15) years. The patients were assessed consecutively from November 2001 to November 2003. Sixty‐three percent of these patients were assigned a protein‐restricted diet (PRD) 0,6–0,8g/kg/day.Results and conclusions — Relatively few patients (13%) were classified as malnourished according to SGA but many reported fatigue, loss of appetite and reduced levels of physical activity. Few patients (6%) were underweight (BMI >20), whereas 58% were overweight (BMI >25). Patients on a PRD did not have impaired NS, compared to patients not on a PRD. Patients who had some degree of malnutrition tended to have reduced HGS. Among male patients, those with a lower level of physical activity tended to have lower HGS. Among the female patients, those who experienced loss of appetite and/or feeling of fatigue tended to have lower HGS. The pre dialysis patients had lower HGS compared to predicted norm for healthy subjects.
RECRUITMENT AND RETENTION AUDIT: TRAINING DOES MAKE A DIFFERENCE
Authors: King J. 
Published: July 2012

SUMMARYThe aim of this study was to find out if offering specialist renal training courses enhanced staff recruitment and retention. An audit of staff with specialist renal skills acquired through training was completed. Analysis of the records available in this Trust since 2003, reporting on staff retention and increased nurse satisfaction following renal course attendance, were used in this study. The research used semi‐structured interviews gaining qualitative data. The participants were all staff who had undertaken renal courses provided by this Trust. The results showed that when the interviews were thematically analysed, key themes emerged, which displayed enhanced insight, confidence and increased skill base. The quantitative data concerning staff retention, staff movement and staff sickness, helped to identify that not only do staff actually stay longer but also appear to develop advanced skills and knowledge as well as more positive attitudes. In summary, it was shown that by offering specialist training there is an increased number of skilled renal nurses presenting for employment attracted by the opportunity of undertaking specialist renal courses. They in return, benefit from the advanced renal programme, which enables them to deliver better quality of care with increased job satisfaction.
PATIENT EDUCATION IN PRE‐DIALYSIS — PATIENT LED FORUMS
Authors: Heatley S.A. 
Published: July 2012

SUMMARYIn order for patients to make an informed choice about renal replacement therapies, it is important that they are given sufficient and appropriate information, which must include explanations about their condition and likely outcomes with or without treatment. Furthermore information regarding the reality of living with dialysis, its strict regimes and patient's commitment to self care are imperative to enable patients to adapt to a life changing, ongoing, often relentless treatment. Encouraging patients to take control of their chronic illness through the provision of education support and choice is fundamental to the successful outcomes of the patient's journey through the pre‐dialysis phase of their illness.This paper describes the implementation of Patient‐led Forums designed to offer an education programme for pre‐dialysis patients and the benefits gained by those who have attended.
PATIENT'S SEXUAL HEALTH: DO WE CARE ENOUGH?
Authors: Ho T.M. , Fernández M. 
Published: July 2012

SUMMARYIt is well documented that sexual problems often accompany chronic health conditions, for example: chronic renal failure, hypertension and diabetes mellitus. One of the responsibilities of a nurse is to provide patients with information concerning their health and treatment to achieve optimum outcomes, thus enhancing patients' quality of life. However, the authors observed that the nursing clinical pathways in their practice seldom reflect the attention given to patient's sexuality.This paper aims to confirm the hypothesis that health professionals do not give sufficient care to patient's sexual health and to define the causes.A descriptive study consisted of close‐ended questionnaire was employed. The medical and nursing staff of a Nephrology Department were included in the study (92.6% response rate). Professionals' opinions on the importance of patient's sexual health, difficulty in addressing this issue and attitude were explored.Staff's opinion on the importance of patient's sexual health is moderately high. However, 86% admit that they do not give sufficient attention and 92% never initiate to address sexual issues to patients. The results reveal the impediment being in relation to awkwardness and deficient sex education in dealing with this subject. Some staff have expressed other deterring factors.This study confirms that professionals do not render sufficient care to patient's sexual health due to their conservative attitude and lack of skill in addressing sexuality. The authors therefore suggest some ways in helping to bridge this gap.