bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in the taphonomic effect of scavengers in semi‐arid Australia linked to rainfall and the El Niño Southern Oscillation
Authors: Brown O. J. F. , Field J. , Letnic M. 
Published: March 2006

AbstractScavenging is one of the primary taphonomic processes shaping the final composition of fossil faunal assemblages. The taphonomic effect of scavengers is variable and must be understood in the context of the causes of that variation. In this study, we investigated relationships between the El Niño Southern Oscillation (ENSO), variable rainfall and scavenging on 20–40 kg mammal carcasses in semi‐arid New South Wales over four years. Following periods of above‐average rainfall (coincident with the La Niña phase of the ENSO), there was an increased availability of non‐carrion food and scavenging activity was moderate. Following below‐average rainfall (coincident with the El Niño phase of the ENSO), foraging options diminished, leading to a greater importance of carrion in the diet of scavengers and a resultant increase in carcass disturbance, transport and destruction by scavengers. Feral pigs (Sus scrofa) and red foxes (Vulpes vulpes) were the most taphonomically significant scavengers in the study. Australian ravens (Corvus coronoides) and wedge‐tailed eagles (Aquila audax) were active scavengers throughout the period of the study, but had little impact on bone survival. Lace monitors (Varanus varius) also fed mostly on soft tissue and were only present seasonally. We found that climate variability in the form of short‐term oscillation can result in significant variation in the impact of scavengers on carcasses and may be an important consideration when evaluating site formation scenarios and biases in fossil faunal assemblages. Copyright © 2006 John Wiley & Sons, Ltd.
A pathway to success
Authors: Gibson Vanessa , Douglas Margaret , Gregg Alan 
Published: March 2006

AbstractIntensive care services have seen a radical increase in provision over the last four years. This, along with the disbanding of the English National Board (ENB), has allowed institutions of higher education to develop targeted, flexible pathways specific to critical care while still incorporating national recommendations. Here, we set out our experience of developing a flexible critical care pathway that is fit for practice (UKCC 1999) and leads to a BSc (Hons) or Higher Education Diploma in Critical Care. We outline the reasons for the course development, the existing continuing professional development framework at Northumbria University and the structure of the new pathway. The planning team endeavoured to incorporate as many recommendations as possible from organizations such as the Audit Commission (1999), the Department of Health (DoH 2000; DoH 2001), and from Scholes and Endacott (2002). The membership of the planning team was also designed to incorporate as many views as possible—from both education and service. We believe that the targeted, flexible pathway offers a number of benefits, including a recognized qualification and a balance of flexibility and standardization over course content. The pathway is open to all healthcare practitioners working in critical care areas; it is competency‐based, offers an opportunity for accreditation for experienced practitioners, and students can either complete the whole pathway or access individual modules according to their, and their employer's, needs. Copyright © 2003 Whurr Publishers Ltd.
Evaluation of an intervention to prevent the early introduction of solid foods to babies
Authors: Nancarrow Susan 
Published: March 2006

AbstractAimTo report on the evaluation of a nutrition intervention that was designed to prevent the early introduction of solid foods to infants and to ensure food texture and variety were age‐appropriate.MethodA nutrition screening tool was administered to consecutive parents for three months by maternal and child health nurses at the two‐ and six‐month immunization schedules. At the two‐month immunization, parents were asked to predict the age at which they proposed to introduce solid foods to their child, and to discuss the factors that influenced their decision‐making. At the six‐month immunization schedule, parents were asked to report the actual age at which they introduced solid foods to their child.ResultsMore than 85% of parents reported that they actually, or intended to, introduce solid foods after their baby was four months of age. There was no relationship between the age of introduction of solid foods and the source or number of information materials received, or the birth order of the child (p>0.05).ConclusionParents in the Australian Capital Territory already have high rates of adherence to existing guidelines for the introduction of solid foods to infants. The timing of a nutritional intervention to coincide with the six‐month immunization schedules was not optimal for this population. Copyright © 2003 Whurr Publishers Ltd.
Learning from near‐misses
Authors: Clinton Colum , Getachew Henok 
Published: March 2006

AbstractWe outline an approach to learning from incidents and near‐misses, based on the key concepts of action research and appreciative enquiry. We illustrate how this approach can be used to bring about developments in patient care, by engaging staff in the change process and supporting the development of a learning culture. Copyright © 2003 Whurr Publishers Ltd.
EPAS: supporting practice development
Authors: Kell Jenny , McSherry Rob , Mudd David 
Published: March 2006

AbstractWe outline the development of the Excellence in Practice Accreditation Scheme (EPAS), devised by the practice development team in the Postgraduate Institute at the University of Teesside, UK. The aim of the EPAS is to provide individuals, teams and organizations with a framework through which professionals can develop, implement and evaluate advances in practice. The scheme incorporates an analysis of organizational accreditation and review schemes that already exist. These have been reviewed to develop a simple yet comprehensive system of practice accreditation. Copyright © 2004 Whurr Publishers Ltd.
Comprehensive service and practice development: city hospitals Sunderland's experience of patient journeys
Authors: Campbell Steve , Watson Bill , Gibson Andrew , Husband Gill , Bremner Ken 
Published: March 2006

AbstractConsiderable effort has been put into the development of integrated care pathways in the NHS in recent years. The notion of integrated care pathways, and even ‘patient journeys’, varies and the terms tend to be used interchangeably. The City Hospitals Sunderland notion of patient journeys is explicit, different, and is making a difference to patients. There are many reasons for this. Here, we describe the conception, development and effect of City Hospital Sunderland's patient journey process. In particular, there is discussion of two features of the process: the mode of patient involvement and the stakeholder sampling of these patients as a form of matrix. Copyright © 2004 Whurr Publishers Ltd.
Do patients with claudication need to see a vascular surgeon? A before and after study of a nurse‐led claudication clinic
Authors: Palfreyman Simon , Trender Hazel , Beard Jonathan 
Published: March 2006

AbstractAn audit of 101 notes comparing patient outcomes and quality indicators before and after the introduction of a vascular nurse specialist claudication clinic was undertaken. The nurse‐led clinics resulted in a reduction in median waiting time from referral to first appointments from 20 weeks to 2 weeks, and a significant reduction (p<0.01) in the number of individual patient appointments. The clinic resulted in a more thorough recording of patient history, assessment information and investigations. Most patients (78% pre‐clinic and 82% post‐clinic) were discharged with no further appointment. The clinic had no effect on the rate of patients who were still smoking at their follow‐up appointments, which remained at 80%. There is also scope to extend the role from assessment and secondary prevention advice to a fully nurse‐led service. This would release vascular surgeons to see other patients and cope with the ever increasing demands for emergency cover. Copyright © 2004 Whurr Publishers Ltd.
Motivating change: using motivational interviewing in practice development
Authors: Walsh Kenneth , McAllister Margaret , Morgan Aerinn , Thornhill Janet 
Published: March 2006

AbstractThe present paper draws on experiences and insights gained by a group of psychiatric nurse practice development facilitators whilst working with consumers, carers, clinicians and managers in the context of a practice development programme in a large metropolitan psychiatric hospital. The paper describes how the practice development facilitators were able to adapt Miller's (Miller 1983; Rollnick and Miller 1995; Miller and Rollnick 2002) techniques of motivational interviewing, commonly used in drug and alcohol treatment services, to help motivate change in an aged care setting. The lessons embedded within this experience are that people do want change, and that sustained change requires ownership and support. Practice development facilitators can assist in this process though the use of principles and strategies of motivational interviewing, which include increasing awareness of the need for change, supporting self‐efficacy and managing resistance to change. Copyright © 2004 Whurr Publishers Ltd.
The practice development accreditation programme at the University of Leeds
Authors: Totterdell Ben 
Published: March 2006

AbstractThe practice development unit accreditation programme offered by the Centre for the Development of Health Care Policy and Practice (CDHPP) at the University of Leeds is now more than 10 years old. Since its inception more than 100 units have been accredited. A high proportion of these units have chosen to stay with the programme, and there are currently approximately 75 active units throughout the UK. There are also 11 units in the Republic of Ireland and four in the USA. Units have been accredited in most specialties ranging from intensive care units in acute hospitals to community residential mental health services. Services from the NHS, voluntary sector and private facilities have been accredited, and more recently a team of education providers has joined the programme. As far as is known, the programme offered by CDHPP is the largest such accreditation programme in the UK, and units continue to join. The programme clearly helps participating units to meet the demands and changes required by the NHS modernization agenda, and so it appears to be as relevant to practitioners as it ever was. It is therefore timely to examine the programme in some detail. Copyright © 2004 Whurr Publishers Ltd.
Development of a self‐management tool in the chronic pain service
Authors: Ruecroft Gill 
Published: March 2006

AbstractA major goal of chronic pain management is the promotion of the individual's ability to self‐manage pain to the greatest extent possible. The persistence of pain and fluctuation of its intensity emphasize the need for the individual's involvement in an ongoing treatment programme. It was hoped that the development of a self‐management tool would, over time, enable patients to develop a repertoire of management techniques/treatments from which to select. Patients who self‐manage their disease may choose to use an alternative to traditional outpatient care, only accessing specialist clinics when their symptoms exacerbate out of their control. Health professionals anticipated that use of the tool would reduce the length of consultations by eliminating the repetition of medical history, description of symptoms and current medications. They were also keen that the tool would produce a partnership approach between the patient and clinicians in primary and secondary care, ensuring patients a continuity of care they were not currently experiencing.The tool was developed and evaluated over 18 months by a group of patients and health professionals. Outcomes were measured after the tool had been issued to 130 patients newly referred over a five‐month period. Qualitative data show an improvement in patients' anxiety and depression levels, an increase in their informed decision‐making, a decrease in their feelings of isolation and an improvement of the patient–health professional partnership in the management of chronic pain. Quantitative data at this early stage do not show a statistically significant change but do show a trend towards a reduction in the new to follow‐up ratio in the clinic.This approach could be used in the management of other chronic conditions to improve patients' health status, change the way they use the service and increase health service provision. Copyright © 2004 Whurr Publishers Ltd.
Valuing people: developing health visiting practice for people with learning disabilities
Authors: Harrison Scott , Plant Anne , Berry Liz 
Published: March 2006

AbstractThe article describes a project undertaken by a health visiting practice development unit, to assist people with learning disabilities access mainstream primary health care services. The lead health visitor, assisted by a community staff nurse and a health co‐ordinator from the Specialist Learning Disabilities Team, devised a programme of health assessment, planning and facilitation to identify and address the health needs of people with a learning disability registered at a large primary care centre in Warrington. Copyright © 2004 Whurr Publishers Ltd.
Developing an ECT integrated care pathway
Authors: Beardsall Lindsey , Gough Julie , Pringle Alan 
Published: March 2006

AbstractThe controversial treatment of electroconvulsive therapy (ECT) remains one of the most emotive issues in mental health. Some nurses have expressed unease about working in this area, often because of the vagueness of the treatment and lack of evidence concerning treatment outcomes. The present paper explores some of these issues and looks at how an integrated care pathway may help to generate evidence about the experience of individuals receiving the treatment, the quality of care given and the effectiveness of the treatment. The paper outlines the development of an integrated care pathway for the ECT clinic at Millbrook Mental Health Unit and describes the multidisciplinary process used to design, develop and evaluate the pathway. The importance of team‐working to ensure ownership of a pathway is explored and changes to the integrated care pathway after evaluation are outlined. Copyright © 2002 Whurr Publishers Ltd.
Does the essence of care live up to patient expectations?
Authors: Stoker Steve , Sayers Amanda 
Published: March 2006

AbstractThe present qualitative study arose from a debate about the provision of fundamental aspects of hospital care for patients with a disability. Like most healthcare organizations, the Newcastle upon Tyne Hospitals NHS Trust is actively seeking new ways to involve patients and carers in future developments, reflecting the increased emphasis placed on service users through documents such as The NHS Plan (DoH 2000a) and The Essence of Care (DoH 2001a). A discussion within a local forum between hospital staff and community representatives elicited a number of personal experiences about hospital care for people with a disability and several possible areas for improvement. The concerns were seen to be linked to The Essence of Care (DoH 2001a) standards, which were already being addressed through different arrangements within the Trust. The specific views of patients with a disability, however, were not reflected in this work at the time. Although potentially difficult, members of the forum agreed that it would be valuable to elicit the views of hospital patients with a disability, or of their carers, in a more systematic way to help to influence future developments. The approach selected to achieve this was a focus group technique, with The Essence of Care (DoH 2001a) topics as the broad subject areas for discussion. The present study aimed to build on and strengthen the existing partnership between the Newcastle upon Tyne Hospitals NHS Trust and Disability North (a local community organization). The findings of the present study demonstrate that patients and carers were extremely willing to give their views on both positive and negative experiences of previous hospital episodes, and these comments will prove valuable in further development of The Essence of Care (DoH 2001a) requirements. The views elicited concentrated on eight key areas: principles of self‐care; food and nutrition; personal and oral hygiene; continence and bladder and bowel care; record‐keeping; pressure ulcers; the safety of patients with mental health needs in acute mental health and general hospital settings; and privacy and dignity. In addition, the findings raised a number of associated pertinent issues, including communication, consent, holistic care, the issue of carers specifically, and organizational elements of healthcare. Copyright © 2002 Whurr Publishers Ltd.
Developing an integrated care pathway for the management of falls and syncope in older people—the Newcastle experience
Authors: Reeve Pam , Harrison Anne , Newton Julia , Troy Anne‐Marie 
Published: March 2006

AbstractSyncopal events (blackouts) and falls are a major health care and cost burden for the NHS, affecting approximately 35% of adults aged more than 65 years living in the community and 45% of adults aged over 80 years. At least 10% of these events result in a fracture. Syncope, and falls are the most common reason for older adults to attend accident and emergency departments. The development of services in relation to falls is an important element of the recently published National Service Framework for Older Persons (www.open.gov.uk/doh/nsf). The present paper describes the development and implementation of an integrated care pathway for the investigation of falls and syncope within a hospital falls and syncope service. Development of the integrated care pathway has facilitated the implementation of evidence‐based investigations and interventions within a multidisciplinary framework and is an approach that could be adopted by other new and existing falls and syncope units. Copyright © 2002 Whurr Publishers Ltd.
Finding a voice—artistic expression and practice development
Authors: Coulson Penelope , Stickley Theodore 
Published: March 2006

AbstractThe present paper describes the development of art activities in a practice development unit in Nottingham, UK. The authors offer theoretical underpinning of their work by discussing the relationship between mental distress and creative expression. It is acknowledged that although there is much interest in the arts in mental health care, research into the subject is in its infancy. It is asserted that by objectifying distress, that is, getting it ‘out there’ instead of holding everying inside, the individual may find release, catharsis and—most importantly—feel listened to. Art enables people to find a voice. The authors argue that people who receive mental health services need more holistic and creative therapies. Whereas holism may be taught in nurse education, the regard for the spiritual or poetic is easily neglected in practice. Two examples are given from practice, first, some illustrations represent some of the work achieved by a group of female mental health service users. Although never intended to be a therapy groupper sethe work was indeed therapeutic. Six women met for a number of weeks in order to express their feelings about the impact of mental illness upon their lives. The results of their work were later displayed in the Trust's own art gallery in Nottingham city centre. The exhibition was a great achievement for the women. The second example given is an exhibition of the work of Arthur Ride, who has been a mental health service user for his adult life. Arthur's work is a series of self‐portraits documenting his ups and downs and periods in acute psychiatric care. A broad understanding of human experience is called for, a view that may encompass the beauty and pain of mental distress. Copyright © 2002 Whurr Publishers Ltd.
Improving patients' hospital experience: team‐working and the integration of non‐clinical and clinical roles
Authors: O'Neill Fiona , Silver Christina 
Published: March 2006

AbstractThe present paper describes a research project that is looking at how non‐clinical support roles may be more fully integrated into the ward team in an acute hospital setting. The research, funded by NHS Estates, is part of the policy of developing evidence‐based support services that is a central strand of NHS modernization. Practice development is a key part of the project design and an action research approach has been adopted to support the development of new ways of integrating both clinical and non‐clinical aspects of care within the multidisciplinary ward team. The research is linked to increasing evidence of the importance of team‐working, not only for the well‐being of healthcare workers but also because of its effect on patient outcomes. The research will make a contribution in this area by focusing on the important relationship between non‐clinical and clinical staff. Copyright © 2002 Whurr Publishers Ltd.
A practice development project for nurses working with older people
Authors: Dewing Jan , Wright Jayne 
Published: March 2006

AbstractThe present paper provides an overview of the first phase of a three‐year practice development programme conducted between Portsmouth NHS Trust, Portsmouth University and the Royal College of Nursing Institute (RCNI) Gerontological Programme. The focus is on the journey of critical companions and programme participants from an elderly medical unit. The programme enabled participants to explore the culture in which they worked, in order to understand beliefs and values about older people embedded in their practice and thus how they shaped the culture around them and could change it. The value of practice development, narrative methodology and work‐based learning methods in creating an evidence‐based and person‐centred culture for care is illustrated. The way in which user perspectives and involvement were established is also shown. Outcomes in the first year, for critical companions and programme participants, are described. Both programme participants and critical companion developed as transformational leaders committed to enabling themselves and others to optimize their abilities and skills. Copyright © 2003 Whurr Publishers Ltd.
Accountability and accreditation in the Australian allied health context
Authors: Nancarrow Susan , Clark Julie 
Published: March 2006

AbstractThe present paper examines the professional accreditation systems developed by five allied health associations in Australia. Professional accreditation is potentially a powerful tool because it can describe both the attributes of a health service provider and aspects of the quality of their care. This information is of value to patients, regulatory bodies and funding organizations to guide their health service decision‐making. However, the lack of consistency in the approaches used by the allied health disciplines means that the term ‘accreditation’ has a different value for each profession. Additionally, patient and purchaser preferences have received little consideration in the development of accreditation systems. Thus, the ability of external purchasers, regulators or patients to use accreditation status to guide decision‐making is limited at best, and at worst risks devaluing the approach at an interdisciplinary level. We present the range of interpretations of professional accreditation adopted by the podiatry, physiotherapy, occupational therapy, dietetics and nutrition and social work associations in Australia. Based on the interdisciplinary variations we argue for the development of a consistent approach to professional accreditation standards and guidelines. Copyright © 2003 Whurr Publishers Ltd.