• Is ultrasound screening for vasa praevia clinically justified and a financially viable screening test? A literature review.

      Coleman, Gillian; Venables, Heather; University of Derby; College of Health and Social Care, University of Derby, Derby, UK; College of Health and Social Care, University of Derby, Derby, UK (Sage, 2018-02-01)
      Vasa praevia is an obstetric complication currently not screened for within the United Kingdom, which if undetected prenatally can lead to fetal death when the membranes rupture. Internationally, guidelines are available providing guidance on the best screening policy and management pathways. However, the UK National Screening Committee and Royal College of Obstetricians and Gynaecologists do not support screening due to a lack of evidence. Recent studies explore the ability of ultrasound to detect vasa praevia prenatally in both the general and high-risk populations. Whilst there is no consensus on the ‘best’ screening strategy, the majority of authors note that targeted screening of the high-risk population is the most achievable and cost-effective strategy. Although not infallible, a standard screening protocol could identify the majority of cases in the high-risk group. Introduction of a screening strategy would affect training needs of professionals within the UK and would have implications on the need to produce guidelines on management and quality assurance. Further research is also needed to define a relevant high-risk population and explore how this would impact on service provision. This review explores the current evidence base for systematic screening and the implications for service.
    • Issues, applications and outcomes in interprofessional education

      Forman, Dawn; University of Derby (MedKnow Publications, 2014-04)
      In this issue, we are very pleased to present six articles, each of which has a strong interprofessional theme and which, we believe, collectively provide a flavor of the diversity of interprofessional community-oriented education, practice and research activity occurring internationally.
    • ‘It’s quite a taboo subject’: an investigation of mother’s experiences of breastfeeding beyond infancy and the challenges they face

      Jackson, Jessica; Hallam, Jenny; University of Derby (Taylor and Francis, 2021-06-10)
      Current recommendations state that women should breastfeed their child up to 2 years and beyond. However, the UK has one of the lowest breastfeeding rates in the world. This could in part be explained by the stigma mothers face when breastfeeding an older child. This research aims to provide a detailed understanding of what motivates women to continue breastfeeding beyond infancy and the barriers they face to (i) add to existing research literature which has examined this area and (ii) support and normalize this practice. Semi-structured interviews were conducted between April and June 2018 with 24 women who had breastfed at least one child past 12 months. A theory-driven thematic analysis identified themes that ran through the interviews centering on the benefits of continued breastfeeding, the stigma mothers faced when breastfeeding past infancy and the challenges of returning to work. The women felt that continued breastfeeding enabled them to play a central role in their child’s health and develop an attachment led parental style but faced social and cultural stigma due to a lack of public awareness of current breastfeeding recommendations. Interventions which raise awareness of breastfeeding beyond infancy are needed to normalize this practice in the UK.
    • Leadership and collaboration: Further developments for interprofessional education

      Forman, Dawn; Jones, Marion; Thistlethwaite, Jill; University of Derby (Palgrave Macmillan, 2015)
      Leadership and Collaboration provides international examples of how leadership of interprofessional education and practice has developed in various countries and examines how interprofessional education and collaborative practice can make a difference to the care of the patient, client and community.
    • Leadership development for interprofessional education and collaborative practice

      Forman, Dawn; Jones, Marion; Thistlethwaite, Jill; University of Derby (Palgrave Macmillan, 2014)
      Leadership Development of Interprofessional Education and Collaborative Practice is an edited compilation of chapters written by international medical and health professional experts. The book provides historical and current perspectives on leadership in healthcare.
    • Leading research and evaluation in interprofessional education and collaborative practice

      Forman, Dawn; Jones, Marion; Thistlethwaite, Jill; University of Derby (Palgrave Macmillan, 2016)
      Expanding upon Leadership Development for Interprofessional Education and Collaborative Practice and Leadership and Collaboration, the third installment to this original and innovative collection of books considers a variety of research models and theories. Emphasizing research and evaluation in leadership aspects, Leading Research and Evaluation in Interprofessional Education and Collaborative Practice
    • Learning and change within person-centred therapy: Views of expert therapists

      Renger, Sue; Macaskill, Ann; Naylor, Bill; Sheffield Hallam University; University of Derby (Wiley, 2020-01-12)
      Traditionally in Person-centred Therapy (PCT) clients are counselled for as long as required. It is a non-directive process. Recently, financial constraints have introduced time limits for therapy in health care, so it seemed appropriate to revisit the practice of PCT in the current UK context. The aim was to explore the concepts of learning and change within PCT and to consider whether learning is facilitated. Five experienced person-centred therapists, who were involved in educating therapists, participated in semi-structured interviews. Questions explored their views on learning and change in therapy, whether learning processes can be facilitated in PCT - both philosophically and practically, and the outcomes of PCT. Therapists were not specifically asked about time pressure but rather it was left to see if it emerged as an issue. Ten major themes emerged; learning and change, goals, learning process, PCT process, issues on non-directivity, questioning, outcomes, assessment and diagnosis, and other methods used. The issue of time pressure permeated many of these themes. Views were often contradictory reflecting the inconclusive views in the literature, particularly in relation to how clients learn and the relationship between change and learning.
    • Local authorities and the education of young people with sickle cell disorders in England.

      Dyson, Simon M.; Abuateya, Hala; Atkin, Karl; Culley, Lorraine A.; Dyson, Sue E.; Rowley, David T. (Routledge, 2008)
      The successful inclusion of minority ethnic pupils with sickle cell disorders (SCD) raises a number of challenges for educational systems. In England, local education authorities were important drivers for innovative responses to complex needs and the former Inner London Education Authority produced guidance in 1989 on SCD in schools. Local education authorities, however, have been superseded by centralised curricula on the one hand and by local management of schools on the other. We know little about the impact of these changes on managing chronic conditions such as SCD. A survey was conducted with 107 local authorities in England to assess responses to needs of pupils with SCD. The majority of authorities did not know the numbers of children with SCD under their jurisdiction, even though most agreed with government guidance that all such children should have individual healthcare plans. Only two had policies on SCD and most authorities referred to generic guidance on pupils with medical needs in schools. The paper concludes, however, that such generic guidance fails in a number of ways to meet the needs of young people with SCD, in terms of prevention, challenging disability discrimination and, crucially, in failing to recognise how ethnicity and racism mediate the experiences of young black disabled students. Developing policies suitable for the education needs of young people with SCD would also help develop the very narrow guidance currently suggested for inclusion of pupils with medical conditions.
    • Looking to the future: Framing the implementation of interprofessional education and practice with scenario planning

      Forman, Dawn; Nicol, Pam; Nicol, Paul; University of Derby (Wolters Kluwer, 2015-12)
      Background: Adapting to interprofessional education and practice requires a change of perspective for many health professionals. We aimed to explore the potential of scenario planning to bridge the understanding gap and framing strategic planning for interprofessional education (IPE) and practice (IPP), as well as to implement innovative techniques and technology for large‑group scenario planning. Methods: A full‑day scenario planning workshop incorporating innovative methodology was designed and offered to participants. The 71 participants included academics from nine universities, as well as service providers, government, students and consumer organisations. The outcomes were evaluated by statistical and thematic analysis of a mixed method survey questionnaire. Results: The scenario planning method resulted in a positive response as a means of collaboratively exploring current knowledge and broadening entrenched attitudes. It was perceived to be an effective instrument for framing strategy for the implementation of IPE/IPP, with 81 percent of respondents to a post‑workshop survey indicating they would consider using scenario planning in their own organisations. Discussion: The scenario planning method can be used by tertiary academic institutions as a strategy in developing, implementing and embedding IPE, and for the enculturation of IPP in practice settings.
    • Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction

      Safari, Reza; University of Derby (SAGE Publications, 2020-11-08)
      The human–prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human–prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.
    • Managing managerialism – how the 21st Century manager can truly thrive.

      Hampson, J.; Howell, T.J.; University of Derby (Youth and Policy, 2018-05)
      Managers embrace the current funding landscape by finding a compromise that allows them to still meet the needs of young people without selling out their values. Managers should be ‘principled pragmatists’, in pursuit of success but cautious to unravel the pedagogy of the profession clearly misunderstood by many commissioners. Rather than seeing targets as limitations, they offer the chance to be creative and refocus work into something truly meaningful. Case studies and narrative enquiries capturing lived experiences can often be the way to a funder’s heart and wallet. By promoting praxis, young people can be involved in the ethical questions around funding projects, in order to avoid teaching young people how to ‘play the system’ and enable them to tackle directly the structural systems of oppression. The socio-political forces continue to both constrain and empower practice, the survival of the profession rests on the shoulders of managers who are able to prove their worth with a foresight for strategy and a passion for people over power. Managers must shed the business-led archetype, acknowledge competitors as potential partners, meet needs less sporadically and use the tools of marketisation to achieve autonomy. By creating services that boast social capital in practitioner expertise, outstanding impactful work can be achieved Youth work is recognised as a distinct pedagogical approach to work with young people, the 21st century manager must be a campaigner where value-driven professionals leading multi-disciplinary teams can co-create change in our communities in spite of commissioners, funders and government.
    • Mental health and wellbeing in parents of excessively crying infants: prospective evaluation of a support package.

      Powell, Charlotte; Bamber, Deborah; Long, Jaqui; Garratt, Rosemary; Brown, Jayne; Rudge, Sally; Morris, Tom; Bhupendra Jaicim, Nishal; Plachcinski, Rachel; Dyson, Sue E.; et al. (John Wiley & Sons Ltd, 2018-04-17)
      Background During the first four months of age, approximately 20% of infants cry a lot without an apparent reason. Most research has targeted the crying and its causes, but there is a need for equal attention to the impact of the crying on parents and subsequent outcomes. This study reports the findings from a prospective evaluation of a package of materials designed to support the wellbeing and mental health of parents who judge their infant to be crying excessively. The resulting ‘Surviving Crying’ package comprised a website, printed materials, and a programme of Cognitive Behaviour Therapy - based support sessions delivered to parents by a qualified practitioner. It was designed to be suitable for National Health Service (NHS) use. Methods Parents were referred to the study by NHS Health Visitors or Community Public Health Nurses. Fifty seven parents of excessively crying babies received the support package and provided rating scale measures of depression, anxiety, frustration because of the crying, and other measures before receiving the support package, together with outcome measures afterwards. Results Significant reductions in depression and anxiety were found with the number of parents meeting clinical criteria for depression or anxiety halving between baseline and outcome. These improvements were not explained by changes in infant crying. Reductions also occurred in the number of parents reporting the crying to be a large or severe problem (from 28 to 3 parents) or feeling very or extremely frustrated by the crying (from 31 to 1 parent). Other findings included increases in parents’ confidence, knowledge of infant crying and improvements in parents’ sleep. Conclusions The findings suggest that the Surviving Crying package may be effective in supporting the wellbeing and mental health of parents of excessively crying babies. Further, large-scale controlled trials of the package in NHS settings are warranted.
    • Metabolic syndrome among type 2 diabetic patients in Sub-Saharan African countries: A systematic review and meta-analysis.

      Shiferaw, Wondimeneh Shibabaw; Akalu, Tadesse Yirga; Gedefaw, Mihretie; Anthony, Denis; Kassie, Ayelign Mengesha; Misganaw Kebede, Worku; Mulugeta, Henok; Dessie, Getenet; Aynalem, Yared Asmare; Debre Berhan University, Ethiopia; et al. (Elseveir, 2020-07-23)
      PubMed, Web of Science, African Journals Online, Google Scholar, Scopus, and Wiley Online Library databases from inception to April 27, 2020 were searched to identify relevant studies. The I2 statistic was used to check heterogeneity across the included studies. DerSimonian and Laird random-effects model was applied to estimate pooled effect size, and 95% confidence interval across studies. A funnel plot and Egger's regression test were used to determine the presence of publication bias. Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. All statistical analyses were done using STATA™ Version 14 software.
    • Multiple emotions, multiple selves: compassion focused therapy chairwork

      Bell, Tobyn; Montague, Jane; Elander, James; Gilbert, Paul; University of Derby (Cambridge University Press (CUP), 2021-07-19)
      Compassion focused therapy (CFT) is rooted in an evolutionary view of the human mind as formed of a multitude of contrasting, and often conflicting, motivations, emotions and competencies. A core aim of the therapy is to help clients understand the nature of their mind in a way that is de-pathologizing and de-shaming. The approach is also focused on the cultivation of compassion to work with these difficult aspects of mind. CFT includes the ‘multiple-selves’ intervention which involves the differentiation of threat-based emotion and an exploration of their conflict. Compassion is then applied to the client’s affective world to aid regulation and integration. This paper focuses on clients’ experiences of a chairwork version of multiple-selves, wherein clients personify their emotions in separate chairs. Nine participants with depression were interviewed directly following the intervention and the resulting data were analysed using interpretative phenomenological analysis. Three interconnecting themes were identified: appreciating emotional complexity; the role of chairwork process; and compassionate integration. The results highlight the importance of emotional differentiation in understanding internal multiplicity and conflict in depression, and the role of compassion in creating a sense of personal coherence. The embodied and enactive nature of chairwork was found to be of benefit in identifying and separating emotion, and in developing new forms of self-relating. The paper discusses the clinical implications of such findings for the treatment of depression.
    • Music, public health, and health promotion: Can music be a social determinant of health?

      Stewart, Donald E; Irons, J. Yoon; Queensland Conservatorium Research Centre, Griffith University (Palgrave Macmillan, 2018)
      This chapter explores the potentials of music as a social determinant of health and resource for psycho-social well-being. Music is encompassed within a socio-ecological definition of health, and from public health perspectives, music promotes well-being through its social participation and community engagement. This chapter offers two case studies, where qualitative and quantitative data attest that participating in music activities can increase well-being from public health perspectives.
    • Music, public health, and health promotion: Can music be a social determinant of health?

      Stewart, Donald E.; Irons, J. Yoon; Griffith University (Palgrave Macmillan, 2018-01-02)
      Although much of the research and policy development relating to the impact of the social determinants of health has centred around differences in socio-economic position, in occupation, income, housing, education and residential environment, for example, we are in the early stages of understanding the complex way that music works within the psycho-social-cultural field to influence people’s health and well-being. Rapid social change and its impact on individual and community well-being provides many fertile opportunities for innovative research in the music-health space. Music is an invisible thread that weaves between the social determinants of health and relates the individual, through culture and social affiliation, to risk and protective factors relating to health.
    • Myalgic Encephalomyelitis / Chronic Fatigue Syndrome and early maladaptive schemas: A single case study.

      Stalmeisters, Dzintra; University of Derby (British Psychological Society, 2018-06-01)
      Background/Aims: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex illness, one that is devastating and life changing for many people. Early maladaptive schemas (EMS), as described by Young et al., (2003), have been observed in some patients with ME/CFS; seemingly adversely impacting on psychological and physical well-being. This study explores the experience of working at schema level with a woman with ME/CFS and endorsed EMS. It provides an overview of the therapeutic treatment, with the aim of adding to the limited research in this area. Method: The instrumental single case study takes place within a clinical context. The client received 20 sessions of therapy. Standard cognitive behavioural therapy (CBT) was initially utilised to work with the client’s depression; once reduced, schema work commenced. Beck’s Depression Inventory (BDI-II) was used to measure mood, and Young’s Schema Questionnaire (YSQ-S3) was employed to measure schemas. Findings: By the end of therapy only two schemas from the nine schemas that the client had endorsed at the start of therapy remained at a level of ‘therapeutic significance’; three schemas diminished once the depression had been treated. The client reported that her quality of life had improved and that she had taken up part-time paid employment. Conclusion: The results appear to offer some support for working at schema level with people that have ME/CFS and also endorse EMS. However, treating existing depression first is recommended.
    • New role raises questions.

      Traynor, Michael; Allan, Helen T.; Dyson, Sue E.; Corbett, Kevin (RCN Publishing Company, 2016-03-16)
      Beware the unintended consequences of the nursing associate role, four leading healthcare figures warn.
    • A non-injected opioid analgesia protocol for acute pain crisis in adolescents and adults with sickle cell disease

      Telfer, Paul; Bestwick, Jonathan; Elander, James; Osias, Arlene; Khalid, Nosheen; Skene, Imogen; Nzouakou, Ruben; Challands, Joanne; Barroso, Filipa; Kaya, Banu; et al. (Sage, 2021-08-02)
      Initial management of the acute pain crisis (APC) of sickle cell disease (SCD) is often unsatisfactory, and might be improved by developing a standardised analgesia protocol. Here, we report the first stages in developing a standard oral protocol for adolescents and adults. Initially, we performed a dose finding study to determine the maximal tolerated dose of sublingual fentanyl (MTD SLF) given on arrival in the acute care facility, when combined with repeated doses of oral oxycodone. We used a dose escalation algorithm with two dosing ranges based on patient’s weight (<50 kg or >50 kg). We also made a preliminary evaluation of the safety and efficacy of the protocol. The study took place in a large tertiary centre in London, UK. Ninety patients in the age range 14–60 years were pre-consented and 31 treatment episodes were evaluated. The first 21 episodes constituted the dose escalation study, establishing the MTD SLF at 600 mcg (>50 kg) or 400 mcg (<50 kg). Further evaluation of the protocol indicated no evidence of severe opioid toxicity, nor increased incidence of acute chest syndrome (ACS). Between 0 and 6 hours, the overall gradient of reduction of visual analogue pain score (visual analogue scale (VAS)) was 0.32 centimetres (cm) per hour (95% confidence interval (CI) = 0.20 to 0.44, p < 0.001). For episodes on MTD SLF, there was median (interquartile range (IQR)) reduction in VAS score of 2.8 cm (0–4.2) and 59% had at least a 2.6-cm reduction. These results are supportive of further evaluation of this protocol for acute analgesia of APC in a hospital setting and potentially for supervised home management.
    • Nurses' knowledge and practice of pressure ulcer prevention and treatment: an observational study

      Saleh, Mohammad; Papanikolaou, Panos; Nassar, Omayyah; Shaheen, Abeer; Anthony, Denis; The University of Jordan; University of Leeds (Elsevier, 2019-10-25)
      To assess nurses’ knowledge on pressure ulcer (PU) prevention and treatment in Jordan, and the frequency of and factors influencing nurses’ implementation of PU prevention and treatment interventions. Highly educated and experienced nurses can provide effective PU care; however, previous studies highlighted poor knowledge and implementation of PU care. Design: A correlational study examining nurses’ knowledge of PU prevention and frequency of PU preventive actions in Jordanian hospitals. Participants were 377 nurses and 318 patients from 11 hospitals. Data were collected to quantify the frequency of nurses’ implementation of pressure ulcer prevention and treatment interventions for patients suffering from PUs and/or at risk of PU development using a self-reported cross-sectional survey and prospective 8-hour observation. For observed PU prevention while type of hospital and number of beds in units were significant it is not known without further work if this is replicable. For observed PU treatment, linear regression analysis revealed significant negative beta values for more than 50 beds in clinical unit (β=-2.49). The study addressed new factors, facilitating the provision of prevention and treatment strategies to PU development, including type of clinical institution and number of beds in clinical unit.