• A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries.

      Liu, Liang Q.; Moody, Julie; Dyson, Sue E.; Traynor, Michael; Gall, Angela (Maney Publishing, 2014-06-26)
      Context: Electrical stimulation (ES) can confer benefit to pressure ulcer (PU) prevention and treatment in spinal cord injuries (SCI). However, clinical guidelines regarding the use of ES for PU management in SCI remain limited. Objectives: To critically appraise and synthesize the research evidence on ES for PU prevention and treatment in SCI. Method: Review was limited to peer-reviewed studies published in English from 1970 to July 2013. Studies included randomized controlled trials (RCTs), non-RCTs, prospective cohort studies, case series, case control and case report studies. Target population included adults with SCI. Interventions of any type of ES were accepted. Any outcome measuring effectiveness of PU prevention and treatment was included. Methodological quality was evaluated using established instruments. Results: Twenty-seven studies were included, 9/27 studies were RCTs. Six RCTs were therapeutic trials. ES enhanced PU healing in all eleven therapeutic studies. Two types of ES modalities were identified in therapeutic studies (surface electrodes, anal probe), 4 types of modalities in preventive studies (surface electrodes, ES shorts, sacral anterior nerve root implant, neuromuscular electrical stimulation implant). Conclusion: The methodological quality of the studies was poor, in particular for prevention studies. A significant effect of ES on enhancement of PU healing is shown in limited Grade I evidence. The great variability in ES parameters, stimulating locations and outcome measure leads to an inability to advocate any one standard approach for PU therapy or prevention. Future research is suggested to improve the design of ES devices, standardize ES parameters and conduct more rigorous trials.
    • A systematic review of neuromuscular electrical stimulation for pressure ulcer care in spinal cord injuries.

      Liu, Liang Q.; Moody, Julie; Dyson, Sue E.; Traynor, Michael; Gall, Angela (2014-09-02)
      Introduction and Aim Pressure ulcer (PU) is one of the most common secondary complications following a spinal cord injury (SCI). Electrical stimulation (ES) can confer the benefit to pressure ulcer care in SCI. However, to date, the clinical guidelines regarding the use of ES for PU management in SCI remain limited. This systematic review was therefore conducted to identify the updated evidence, and to pinpoint the scope of the feasibility of future studies implementing electrical stimulation for PU management in SCI. The overall aim of this review was to critically appraise and synthesize the research evidence on neuromuscular ES for the prevention and treatment of PU in spinal cord injuries. Material and Method Review was limited to peer-reviewed studies published in English from 1970 to 2013. A Free-text and keyword/MESH terms search of five databases (Medline, CINAHL, EMBASE, PsycINFO and the Cochrane Central Register of Controlled Trials.), in addition to manual searches of other resources and retrieved articles was undertaken on 18th July 2013. Studies included randomized controlled trials (RCTs), non-randomized controlled trials, prospective cohort studies, case series, case control studies and case report studies. Target population included adults with SCI. Interventions of any type of neuromuscular ES were accepted. Any outcome measuring the effectiveness of PU prevention and treatment was included. Methodological quality was evaluated using established instruments by two independent reviewers. Results Twenty-seven studies were included in this review, 9/27 studies were RCTs. Six of RCTs were therapeutic trials. ES enhanced PU healing in all therapeutic studies. The evidence of long-term benefit of ES for pressure ulcer prevention is uncertain. Five types of ES modalities (surface electrodes, ES shorts, sacral anterior nerve root implant, neuromuscular electrical stimulation implant and anal probe) were identified in this review. Conclusion The great variability in the parameters and locations of ES application and outcome measure leads to an inability to advocate any one standard therapeutic approach for PU therapy or prevention. The methodological quality of the studies was generally poor, in particular for those prevention studies. Future research is suggested to improve the design of ES devices, standardize ES parameters and conduct more rigorous trials.
    • The acceptability of iterative reconstruction algorithms in head CT: An assessment of sinogram affirmed iterative reconstruction (SAFIRE) vs. filtered back projection (FBP) using phantoms

      Harris, Matine; Huckle, John; Anthiny, Denis; Charnock, Paul; University of Leeds (Elsevier, 2017-05-31)
      Computed tomography (CT) is the primary imaging investigation for many neurologic conditions with a proportion of patients incurring cumulative doses. Iterative reconstruction (IR) allows dose optimization, but head CT presents unique image quality complexities and may lead to strong reader preferences. OBJECTIVES: This study evaluates the relationships between image quality metrics, image texture, and applied radiation dose within the context of IR head CT protocol optimization in the simulated patient setting. A secondary objective was to determine the influence of optimized protocols on diagnostic confidence using a custom phantom. METHODS AND SETTING: A three-phase phantom study was performed to characterize reconstruction methods at the local reference standard and a range of exposures. CT numbers and pixel noise were quantified supplemented by noise uniformity, noise power spectrum, contrast-to-noise ratio (CNR), high- and low-contrast resolution. Reviewers scored optimized protocol images based on established reporting criteria. RESULTS: Increasing strengths of IR resulted in lower pixel noise, lower noise variance, and increased CNR. At the reference standard, the image noise was reduced by 1.5 standard deviation and CNR increased by 2.0. Image quality was maintained at </=24% relative dose reduction. With the exception of image sharpness, there were no significant differences between grading for IR and filtered back projection reconstructions. CONCLUSIONS: IR has the potential to influence pixel noise, CNR, and noise variance (image texture); however, systematically optimized IR protocols can maintain the image quality of filtered back projection. This work has guided local application and acceptance of lower dose head CT protocols.
    • An agenda for best practice research on group singing, health, and well-being

      Dingle, Genevieve A.; Clift, Stephen; Finn, Saoirse; Gilbert, Rebekah; Groarke, Jenny M; Irons, J. Yoon; Jones-Bartoli, Alice; Lamont, Alexandra; Launay, Jacques; Martin, Eleanor S; et al. (Sage, 2019-07-10)
      Research on choirs and other forms of group singing has been conducted for several decades and there has been a recent focus on the potential health and wellbeing benefits, particularly in amateur singers. Experimental, quantitative and qualitative studies show evidence of a range of biopsychosocial and wellbeing benefits to singers; however, there are many challenges to rigour and replicability. To support the advances of research into group singing, the authors met and discussed theoretical and methodological issues to be addressed in future studies. The authors are from five countries and represent the following disciplinary perspectives: music psychology, music therapy, community music, clinical psychology, educational and developmental psychology, evolutionary psychology, health psychology, social psychology, and public health. This paper summarises our collective thoughts in relation to the priority questions for future group singing research, theoretical frameworks, potential solutions for design and ethical challenges, quantitative measures, qualitative methods, and whether there is scope for a benchmarking set of measures across singing projects. With eight key recommendations, the paper sets an agenda for best practice research on group singing.
    • Alcohol health literacy in young adults with Type 1 diabetes and its impact on diabetes management.

      Barnard, K. D.; Dyson, P.; Sinclair, J. M. A.; Lawton, J.; Anthony, Denis; Cranston, M.; Holt, R. I. G.; University of Leeds; Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK; OCDEM; University of Oxford; OCDEM Churchill Hospital; Oxford UK; et al. (Wiley, 2014-05-13)
      AIMS: To investigate the knowledge of alcohol and carbohydrate content of commonly consumed alcoholic drinks among young adults with Type 1 diabetes and to explore alcohol consumption while identifying diabetes self-management strategies used to minimize alcohol-associated risk. METHOD: We conducted an open-access, multiple-choice web survey to investigate knowledge of alcohol and carbohydrate content of typical alcoholic drinks using images. Respondents to the survey also recorded their current alcohol consumption and diabetes self-management strategies when drinking. RESULTS: A total of 547 people aged 18-30 years responded to the survey (341 women; 192 men; mean (sd) age 24.5 (3.7) years), of whom 365 (66.7%) drank alcohol. In all, 84 (32.9%) women and 31 (22.6%) men scored higher than the cut-off score for increased-risk drinking. Knowledge accuracy of alcohol units was poor: only 7.3% (n = 40) correctly identified the alcohol content of six or more out of 10 drinks. Knowledge of carbohydrate content was also poor: no respondent correctly identified the carbohydrate content of six or more out of 10 drinks. Various and inconsistent strategies to minimize alcohol-associated risk were reported. CONCLUSIONS: Alcohol consumption was common among the survey respondents, but knowledge of alcohol and carbohydrate content was poor. Greater alcohol-related health literacy is required to minimize alcohol-associated risk. Further research should help develop effective strategies to improve health literacy and support safe drinking for young adults with Type 1 diabetes.
    • An exploratory study to identify risk factors for the development of capecitabine-induced palmar plantar erythrodysesthesia (PPE).

      Law, Annie; Dyson, Sue E.; Anthony, Denis (Wiley, 2015-02)
      Aims: to identify pre-treatment risk factors for the development of Palmar Plantar Erythrodysesthesia in participants receiving capecitabine monotherapy. Specifically the hypothesis that avoidance of activities that cause friction and pressure cause Palmar Plantar Erythrodysesthesia was tested. Background. Previous literature showed contradictory evidence on the subject of predictors of chemotherapy-induced Palmar Plantar Erythrodysesthesia. There is a lack of empirical evidence to support the theory that Palmar Plantar Erythrodysesthesia is caused by damage to the microcapillaries due to everyday activities that cause friction or pressure to the hands or feet. Design. Prospective epidemiological study of risk factors. Methods. Prospective data collection. All patients prior to commencing capecitabine monotherapy between 11 June 2009–31 December 2010, were offered recruitment into the study and followed up for six cycles of treatment (n = 174). Data were collected during semi-structured interviews, from participants’ diaries, physical examination of the hands and feet and review of notes. Data relating to activities that cause friction, pressure or heat were collected. Data were analysed using bivariate (chi-square and independent groups Student’s t) tests where each independent variable was analysed against Palmar Plantar Erythrodysesthesia. Results. The only variables that were associated with an increased risk of Palmar Plantar Erythrodysesthesia were a tendency to have warm hands and pre-existing inflammatory disease. Conclusions. This study gives no support for the hypothesis that avoidance of activities that cause friction and pressure cause Palmar Plantar Erythrodysesthesia.
    • Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review

      Mohseni-Bandpei, Mohammad Ali; Nakhaee, Masoomeh; Mousavi, Mohammad Ebrahim; Shakourirad, Ali; Safari, Mohammad Reza; Vahab Kashani, Reza; University of Social Welfare and Rehabilitation Sciences (Elsevier, 2014-05-03)
      Plantar fasciitis (PFS) is one of the most common causes of heel pain, estimated to affect 10% of the general population during their lifetime. Ultrasound (US) imaging technique is increasingly being used to assess plantar fascia (PF) thickness, monitor the effect of different interventions and guide therapeutic interventions in patients with PFS. The purpose of the present study was to systematically review previously published studies concerning the application of US in the assessment of PF in patients with PFS. A literature search was performed for the period 2000-2012 using the Science Direct, Scopus, PubMed, CINAHL, Medline, Embase and Springer databases. The key words used were: ultrasound, sonography, imaging techniques, ultrasonography, interventional ultrasonography, plantar fascia and plantar fasciitis. The literature search yielded 34 relevant studies. Sixteen studies evaluated the effect of different interventions on PF thickness in patients with PFS using US; 12 studies compared PF thickness between patients with and without PFS using US; 6 studies investigated the application of US as a guide for therapeutic intervention in patients with PFS. There were variations among studies in terms of methodology used. The results indicated that US can be considered a reliable imaging technique for assessing PF thickness, monitoring the effect of different interventions and guiding therapeutic interventions in patients with PFS.
    • Art therapy, arts-based research and transitional stories of domestic violence and abuse

      Bird, Jamie; University of Derby (Taylor and Francis, 2017-05-05)
      Visual imagery within qualitative research is an established method of gathering data that has parallels to the way in which images are used within art therapy. This paper explores how visual imagery was used to investigate women’s responses to domestic violence and abuse and examines how art therapy principles shaped the development and conducting of that research. Through the use of collage, participants created visual representations of their responses to experiences of domestic violence and abuse. The visual representations were, when combined with spoken words, created stories that reference the past, present and future. The stories created have been termed transitional stories of domestic violence. These stories show that the home has special significance for women as they transition away from domestic violence and plan for their future. The home becomes both a metaphorical and physical manifestation and container of hopes for a harmonious future that often incorporates the desire for the return to the idea of a complete family. This paper will present the findings of the arts-based research conducted, and consider the implications upon art therapy practice of those findings.
    • Attributes of effective interprofessional placement facilitation

      Nicol, Paul; Forman, Dawn; University of Derby (Canadian Institute for Studies in Publishing Press, 2014-10)
      Background: The quality of facilitation is an important influence on the efficacy of interprofessional education (IPE) delivery. The research objective was to increase understanding of the attributes of effective facilitation of students during external IPE placements in primary care situations. Methods and Findings: A thematic analysis of the experiences of academics, students, and placement-site staff at three placement sites was employed to explore participants’ perceptions of the attributes of effective IPE facilitators. These attributes included experience in an interprofessional context, together with an understanding of the specific clinical and assessment requirements of different disciplines. Facilitators also needed empathy with respect to the requirements of the external IPE placement sites and the ability to liaise between student and site needs. Conclusions: Models of IPE placement facilitation were most effective when, while following general principles, facilitators tailored them specifically for the individual situations of the placement sites and the learning requirements of particular groups of students. The most rewarding IPE learning experiences occurred when IPE facilitators provided sufficient clinical opportunities for students to work collaboratively with individual clients, provided the students perceived that their participation was relevant to their own discipline.
    • Attributes of effective interprofessional placement facilitation

      Nicol, Paul; Forman, Dawn; Universty of Derby (Canadian Institute for Studies in Publishing Press, 2014-10)
      Background: The quality of facilitation is an important influence on the efficacy of interprofessional education (IPE) delivery. The research objective was to increase understanding of the attributes of effective facilitation of students during external IPE placements in primary care situations. Methods and Findings: A thematic analysis of the experiences of academics, students, and placement-site staff at three placement sites was employed to explore participants’ perceptions of the attributes of effective IPE facilitators. These attributes included experience in an interprofessional context, together with an understanding of the specific clinical and assessment requirements of different disciplines. Facilitators also needed empathy with respect to the requirements of the external IPE placement sites and the ability to liaise between student and site needs. Conclusions: Models of IPE placement facilitation were most effective when, while following general principles, facilitators tailored them specifically for the individual situations of the placement sites and the learning requirements of particular groups of students. The most rewarding IPE learning experiences occurred when IPE facilitators provided sufficient clinical opportunities for students to work collaboratively with individual clients, provided the students perceived that their participation was relevant to their own discipline.
    • The body of work as a legitimate form of independent scholarship.

      Bird, Jamie; Stephanou, Mary; Wellen, Allessandar; University of Derby (Routledge, 2018-10-25)
      This chapter will outline key principles that underpin the use of creativity within final-year projects of undergraduate and postgraduate programmes. It will set forth a rational for directing students towards using a particular form of arts-based research that aids critical thinking and reflexivity whilst engaging in art practice. The programmes referenced in this chapter are delivered at the University of Derby. The undergraduate programme – Creative Expressive Therapies – is outlined in detail within other chapters of this book. The post-graduate programmes include Art Therapy, Dramatherapy and Dance and Movement Psychotherapy. Those postgraduate programmes are regulated by various professional bodies and lead to students being able to practice in their chosen field. What those programmes share is the placing of creativity, art-making and performance at the heart of their pedagogic philosophy and practice. What they also share is a focus upon the therapeutic use of creativity and the therapeutic use of self. Whilst the undergraduate programmes are positioned within an arts in health and arts in education paradigm, the post-graduate programmes are broadly psychotherapeutic in their approach to creativity and therapeutic relationships. Either way, a better understanding of the role of the therapeutic use of creativity and self is enhanced by embedding both into the process of independent scholarship.
    • Broken biosecurity? Veterinarians’ framing of biosecurity on dairy farms in England

      Shortall, Orla; Ruston, Annmarie; Green, Martin; Brennan, Marnie; Wapenaar, Wendela; Kaler, Jasmeet; University of Derby; University of Nottingham; Canterbury Christ Church University (Elsevier, 2016-06-04)
      There is seen to be a need for better biosecurity – the control of disease spread on and off farm – in the dairy sector. Veterinarians play a key role in communicating and implementing biosecurity measures on farm, and little research has been carried out on how veterinarians see their own and farmers’ roles in improving biosecurity. In order to help address this gap, qualitative interviews were carried out with 28 veterinarians from Royal College of Veterinary Surgeon farm accredited practices in England. The results were analysed using a social ecology framework and frame analysis to explore not only what barriers vets identified, but also how vets saw the problem of inadequate biosecurity as being located. Veterinarians’ frames of biosecurity were analysed at the individual, interpersonal and contextual scales, following the social ecology framework, which see the problem in different ways with different solutions. Farmers and veterinarians were both framed by veterinarians as individualised groups lacking consistency. This means that best practice is not spread and veterinarians are finding it difficult to work as a group to move towards a “predict and prevent” model of veterinary intervention. But diversity and individualism were also framed as positive and necessary among veterinarians to the extent that they can tailor advice to individual farmers. Veterinarians saw their role in educating the farmer as not only being about giving advice to farmers, but trying to convince the farmer of their perspective and values on disease problems. Vets felt they were meeting with limited success because vets and farmers may be emphasising different framings of biosecurity. Vets emphasise the individual and interpersonal frames that disease problems are a problem on farm that can and should be controlled by individual farmers working with vets. According to vets, farmers may emphasise the contextual frame that biosecurity is largely outside of their control on dairy farms because of logistical, economic and geographical factors, and so some level of disease on dairy farms is not entirely unexpected or controllable. There needs to be a step back within the vet-farmer relationship to realise that there may be different perspectives at play, and within the wider debate to explore the question of what a biosecure dairy sector would look like within a rapidly changing agricultural landscape
    • Care of the person with dementia : interprofessional practice and education

      Forman, Dawn; Pond, Dimity; University of Derby; Newcastle University Australia (Cambridge University Press, 2015-11)
      Care of the Person with Dementia responds to the urgent need for health practitioners to take an innovative approach to the challenge of dementia. The first Australian text of its kind, it combines evidence-based resources with interprofessional education and practice, exploring the ethical, social and environmental repercussions of dementia to provide a comprehensive overview of dementia care in an Australian context. The text is structured around a model of interprofessional education and practice (IPE) tailored to dementia care. This model incorporates the context of care, an important element missing from other recognised models of IPE. Throughout the book, principles of IPE are explained within the context of dementia, drawing on exemplars from a body of current, well-researched and evaluated dementia practice. Written by experienced academics, and providing national and international perspectives, this is a unique and crucial resource to develop collaborative skills and professional knowledge in the management of dementia.
    • Challenges facing the farm animal veterinary profession in England: A qualitative study of veterinarians’ perceptions and responses

      Ruston, Annmarie; Shortall, Orla; Green, Martin; Brennan, Marnie; Wapenaar, Wendela; Kaler, Jasmeet; University of Derby; Univeristy of Nottingham; Canterbury Christ Church University (Elsevier, 2016-05-14)
      The farm animal veterinary profession in the UK has faced a number of challenges in recent decades related to the withdrawal of government funding and a contraction of the agricultural sector. They have come under pressure to respond by developing skills and focusing on disease prevention advisory services. However, this puts veterinarians in competition with other providers of these services, and moves in this direction have only been partial. Failure to respond to these challenges puts the veterinary profession at risk of de-professionalisation—a loss of their monopoly over knowledge, an erosion of client beliefs in their service ethos and a loss of work autonomy. This paper explores how farm animal veterinarians in England perceive these challenges and are responding to them. Semi-structured qualitative interviews were carried out with 28 veterinarians from Royal College of Veterinary Surgeon farm accredited practices. Veterinarians were chosen from high, medium and low density cattle farming regions. Interviews were recorded, transcribed and themes identified through the constant comparison method. The majority of respondents recognised the challenges facing the veterinary profession. Most believed their role had changed, moving towards that of a disease prevention adviser who was part of the farm management team. In terms of maintaining and redefining their professional status, farm animal veterinarians do have a defined body of knowledge and the ability to develop trusting relationships with clients, which enhances their competitiveness. However, while they recognise the changes and challenges, moves towards a disease prevention advisory model have only been partial. There seem to be little effort towards using Farm accreditation status or other strategies to promote their services. They do not appear to be finding effective strategies for putting their knowledge on disease prevention into practice. Disease prevention appears to be delivered on farm on an ad hoc basis, they are not promoting their disease prevention services to farmers effectively or using their professional position to stave off competition. Farm animals veterinarians will need to realign their veterinary expertise to the demands of the market, work together rather than in competition, improve their skills in preventive medicine, consolidate information given by non-veterinary advisors, develop new business models appropriate to their services and develop entrepreneurial skills to demonstrate their market value if they are to avoid becoming marginalised
    • Cochrane systematic review singing for people with parkinson’s: preliminary findings

      Irons, J. Yoon; coren, Esther; Young, Megan K; Gschwandtner, Manfred; Stewart, Donald E; Mellick, George D; Health and Social Care Research Centre, University of Derby (University of Derby, 2019-06-05)
      This is a Conference (5th World Parkinson's Congress) poster based on the on-going Cochrane Systematic review on the effects of singing for people with Parkinson's.
    • Community Interventions for Health (CIH): A monograph

      Dyson,Pamela; Anthony, Denis; University of Oxford (Oxford Health Alliance, 2015)
      Non communicable disease (NCD), including cardiovascular disease, cancer, diabetes and chronic respiratory diseases, accounted for over 65.5% of deaths in 2010, with more than 80% of these occurring in low and middle income countries (LMIC). Approximately 30% of the deaths in LMIC occur prematurely and are largely preventable. NCD is also associated with increased morbidity and reduced quality of life, and it has been estimated that the global economic impact of NCD could total US$47 trillion over the next twenty years, equivalent to 5% of GDP. The causes of NCD have their roots in three major modifiable risk factors; tobacco use, physical inactivity and unhealthy diet and prevention of NCD by addressing these factors at the community level is fast becoming an area of interest. Most authorities, including the United Nations (UN), the World Health Organisation (WHO) and the US Center for Disease Control and Prevention (CDC) recommend evidence based strategies for lifestyle interventions, but there is limited high grade evidence for population or community based approaches and most of the available evidence is derived from studies conducted in high risk individuals in high income countries. The population approach is inclusive and addresses many factors including health education, structural environmental change, engagement of health providers, transport and education ministries, policy and legislative initiatives and partnerships and coalitions with community organisations. In 2008, the Oxford Health Alliance, a UK registered health charity (No 1117580), began its Community Interventions for Health (CIH) program which was designed to utilise this population approach and which adopted multi factorial, comprehensive strategies for prevention of NCD by addressing modifiable lifestyle risk factor reduction. CIH is an international collaborative study that took place between 2008 2011 in communities in China, India and Mexico and was designed to reduce the risk of NCD by targeting the three main risk factors of tobacco use, physical inactivity and unhealthy diet. The aim of CIH was to evaluate culturally specific strategies to (i) decrease the prevalence of smoking and smokeless tobacco use, (ii) improve diet by increasing intake of fruit and vegetables and reducing use of salt and (iii) increase levels of physical activity in local communities in India, China and Mexico. CIH was conducted over 5 years, and showed that population based strategies to improve health were effective in adults, and had a positive impact on risk factors for NCD by improving dietary intake and ameliorating secular trends for reduced physical activity and increases in overweight and obesity.
    • Community Interventions for Health can support clinicians in advising patients to reduce tobacco use, improve dietary intake and increase physical activity.

      Anthony, Denis; Dyson, Pamela A; Lv, Jun; Thankappan, Kavumpurathu Raman; Champgane, Beatriz; Matthews, David R; University of Leeds; University of Oxford; Sree Chitra Tirunal Institute for Medical Sciences and Technology; International American Heart Organisation; et al. (Wiley, 2016-07-25)
      AIMS AND OBJECTIVES: To increase clinical interventions to reduce modifiable risk factors for noncommunicable disease in low- and middle-income countries. BACKGROUND: Noncommunicable disease is the leading cause of death in the world and is common in low- and middle-income countries. Risk factors for noncommunicable disease are modifiable and health professionals are in an unique position to intervene and influence them. DESIGN: Clinical interventions were used as part of the Community Interventions for Health programme, a nonrandomised, controlled study undertaken in three communities - one each in China, India and Mexico. METHODS: All clinicians in intervention and control areas of the study were invited to complete surveys. A total of 2280 completed surveys at baseline and 2501 at follow-up. Culturally appropriate interventions to reduce tobacco use, improve dietary intake and increase physical activity were delivered in the intervention areas. RESULTS: Clinicians in the intervention group felt more prepared to advise smoking cessation and improvement of diet. They were more likely to test serum cholesterol and blood pressure, but less likely to take measurements of height, hip, waist and skin-fold thickness. There were more resources available to clinicians in the intervention group and they used counselling more and complementary medicine less than those in the control group. CONCLUSIONS: Community interventions which have been shown to have a positive effect in the community and workplace also change clinical practice. RELEVANCE TO CLINICAL PRACTICE: Community interventions make clinicians, including nurses, more likely to feel prepared to offer advice and more likely to use counselling. This would be expected to reduce risk factors in patients.
    • A comparison of the performance of the Braden Q and the Glamorgan paediatric pressure ulcer risk assessment scales in general and intensive care paediatric and neonatal units.

      Willock, Jane; Habiballah, Laila; Long, Deborah; Palmer, Kelli; Anthony, Denis; University of Leeds; University of Oxford (Elsevier, 2016-03-15)
      Aims To compare the predictive ability of two risk assessment scales used in children. Background There are several risk assessment scales (RASs) employed in paediatric settings but most have been modified from adult scales such as the Braden Q whereas the Glamorgan was an example of a scale designed for children. Methods Using incidence data from 513 paediatric hospital admissions, receiver operating characteristic (ROC) was employed to compare the two scales. The area under the curve (AUC) was the outcome of interest. Results The two scales were similar in this population in terms of area under the curve. Neonatal and paediatric intensive care were similar in terms of AUC for both scales but in general paediatric wards the Braden Q may be superior in predicting risk. Conclusion Either scale could be used if the predictive ability was the outcome of interest. The scales appear to work well with neonatal, paediatric intensive care and general children’s wards. However the Glamorgan scale is probably preferred by childrens’ nurses as it is easy to use and designed for use in children. There is some suggestion that while the two scales are similar in intensive care, for general paediatrics the Braden Q may be the better scale.
    • Competencies and frameworks in interprofessional education: A comparative analysis

      Thistlethwaite, Jill; Forman, Dawn; Matthews, Lynda; Rogers, Gary; Steketee, Carole; Yassine, Tagrid; University of Derby (Wolters Kluwer, 2014-06)
      Health professionals need preparation and support to work in collaborative practice teams, a requirement brought about by an aging population and increases in chronic and complex diseases. Therefore, health professions education has seen the introduction of interprofessional education (IPE) competency frameworks to provide a common lens through which disciplines can understand, describe, and implement team-based practices. Whilst an admirable aim, often this has resulted in more confusion with the introduction of varying definitions about similar constructs, particularly in relation to what IPE actually means.The authors explore the nature of the terms competency and framework, while critically appraising the concept of competency frameworks and competency-based education. They distinguish between competencies for health professions that are profession specific, those that are generic, and those that may be achieved only through IPE. Four IPE frameworks are compared to consider their similarities and differences, which ultimately influence how IPE is implemented. They are the Interprofessional Capability Framework (United Kingdom), the National Interprofessional Competency Framework (Canada), the Core Competencies for Interprofessional Collaborative Practice (United States), and the Curtin University Interprofessional Capability Framework (Australia).The authors highlight the need for further discussion about establishing a common language, strengthening ways in which academic environments work with practice environments, and improving the assessment of interprofessional competencies and teamwork, including the development of assessment tools for collaborative practice. They also argue that for IPE frameworks to be genuinely useful, they need to augment existing curricula by emphasizing outcomes that might be attained only through interprofessional activity
    • Conflict management styles used by nurses in Jordan

      Al-Hamdan, Zaid; Norrie, Peter; Anthony, Denis; University of Leeds; Jordan University of Science and Technology, Jordan; De Montfort University, Leicester; Assistant Professor, Faculty of Nursing, Jordan University of Science and Technology, Jordan; Principal Lecturer and Senior Research Fellow, School of Nursing and Midwifery, De Montfort University, UK; Professor of Nursing, School of Nursing and Midwifery, De Montfort University, UK (Sage, 2014-02-01)
      The aim of this study is to investigate the conflict management styles used by nurse managers in Jordan. There are five main styles which nurse managers use to deal with conflict. At present research into their utilisation is dominated by reports from Western countries. This research is the second to investigate their use by nurses in an Arab country and it illustrates both similarities and differences with this earlier work, allowing an initial profile to be constructed which may be applicable to the larger Arab world of health care. Cross sectional quantitative survey of nurse managers in Jordan. The Rahim Organisation Conflict Inventory (ROCI II) questionnaire was completed by 350 (83% response).The nurse managers were most likely to use an integrating style of conflict management, followed in rank order by comprising, obliging, dominating and avoiding. A tentative model of the styles which nurse managers in Arab countries use to manage conflict is proposed, which suggests that these managers are likely to provide stable workplaces.