McCabe T.,NHS Lanarkshire
Psychiatrist | Year: 2017
Air travel is now a common feature of most of our elderly population's lives. There is little by way of warnings, rules or recommendations for our patients with psychiatric diagnoses, in particular dementia, who intend to travel by plane, in contrast to other specialties. In this article I highlight an adverse outcome of long-haul air travel as a result of delirium and resulting accelerated decline in overall cognitive function. I review literature related to the topic and suggest ways to minimise precipitating factors for stressors prior to and during flights. This article suggests that more thought should be given to the title question.
Maguire R.,University of Surrey |
Kotronoulas G.,University of Surrey |
Simpson M.,NHS Lanarkshire |
Paterson C.,Ninewells Hospital
Gynecologic Oncology | Year: 2015
Background: Women with cervical cancer constitute a patient population in need for ongoing, person-centred supportive care. Our aim was to synthesise current available evidence with regard to the supportive care needs of women living with and beyond cervical cancer. Methods: A systematic review was conducted according to the PRISMA Statement guidelines. Seven electronic databases (DARE, Cochrane, MEDLINE, CINAHL, BNI, PsychINFO and EMBASE) were searched to identify studies employing qualitative and/or quantitative methods. Pre-specified selection criteria were applied to all records published between 1990 and 2013. Methodological quality evaluation was conducted using the standardised QualSyst evaluation tool. Findings: were integrated in a narrative synthesis. Findings Of 4936 references initially retrieved, 15 articles (13 unique studies) met eligibility criteria. One study fell below a pre-specified 55% threshold of methodological quality and was excluded. Individual needs were classified into ten domains of need. Interpersonal/intimacy (10; 83.3%), health system/information (8; 66.7%), psychological/emotional (7; 58.3%) and physical needs (6; 50%) were those most frequently explored. Spiritual/existential (1; 8.3%), family-related (2; 16.7%), practical (2; 16.7%), and daily living needs (2; 16.7%) were only rarely explored. Patient-clinician communication needs and social needs were addressed in 4 studies (33.3%). Dealing with fear of cancer recurrence, concerns about appearance/body image, lack of sexual desire, requiring more sexuality-related information, dealing with pain, and dealing with difficulties in relationship with partner were the most frequently cited individual needs (≥ 4 studies). Conclusions: Despite a host of additional needs experienced by women with cervical cancer, a predominant focus on sexuality/intimacy and information seeking issues is noted. Study limitations preclude drawing conclusions as to how these needs evolve over time from diagnosis to treatment and subsequently to survivorship. Whether demographic or clinical variables such as age, race/ethnicity, disease stage or treatment modality play a moderating role, only remains to be answered in future studies. © 2014 Elsevier Inc. All rights reserved.
Agency: European Commission | Branch: FP7 | Program: BSG-SME | Phase: SME-2012-1 | Award Amount: 1.45M | Year: 2012
Cleanward aims to develop a novel, safe, user-friendly anti-microbial cleaning system, using titanium dioxide coated ultra-microfibre fabric that will integrate easily into existing contract cleaning equipment: it will achieve log105 microbial removal and the coating will react with water and UV to produce a highly reactive environment: this will kill all harmful micro-organisms quickly and thoroughly without the need for chemical disinfectant all in an isolated, low water volume unit. The cloths will then be available for re-use without running the risk of microbiological cross contamination.
Agency: European Commission | Branch: FP7 | Program: BSG-SME | Phase: SME-2011-1 | Award Amount: 1.25M | Year: 2011
In PreventDFU, we propose to develop an advanced prototype for prophylaxis and treatment of diabetic foot ulcers (DFUs). This condition contributes to morbidity and loss of Quality of Life (QoL) of Diabetes Mellitus sufferers, most especially the elderly. We propose to develop a unit prototype, based on our proprietary pulsating negative pressure technology that can be used at home or nursing homes, for treatment of DFUs, and their prevention. Over 55Mn Europeans between 20 and 79 years of age are currently suffering from diabetes; 55% above 60 years old. The incidence of diabetes is expected to grow as the population ages. Diabetes sufferers have a 12 to 25% lifetime risk of developing a DFU. Over 8Mn Europeans coudl be suffering from DFU in their lifetime. A morbid display of DFU is the lower limb amputation; 85% of the amputations in diabetes sufferers are reported after unsuccessful DFU treatment this means between 290,000 and 450,000 amputations per year, an annual cost in the order of 2 2.5Bn. We believe that introducing PreventDFU technology for home and nursing home use for the primary purpose of DFU prophylaxis during sleeping hours and for the secondary purpose of assistive therapy of mild DFUs may reduce DFU incidence in the elderly and prevent a significant number of DFU-related toe, foot and leg amputations. If Prevent DFU technology can only help 5% of the DFU sufferers, this would mean substantial QoL improvement for over 400,000 Europeans and over 2 Mn sufferers worldwide, substantially reduce associated healthcare costs and give a considerable boost to the European Medical Device Manufacturing, Nursing and Assisted Living sectors. PreventDFU technology could benefit elderly pressure ulcer (PU) suffers by providing timely prophylaxis by increasing the blood flow in the legs; it has been reported that 95% of all pressure ulcers occur in the lower part of the body while 70% of those occur in persons over 65 years of age.
Manghat P.,Darent Valley Hospital |
Sodi R.,NHS Lanarkshire |
Swaminathan R.,St Thomas Hospital
Annals of Clinical Biochemistry | Year: 2014
Recent studies of inherited disorders of phosphate metabolism have shed new light on the understanding of phosphate metabolism. Phosphate has important functions in the body and several mechanisms have evolved to regulate phosphate balance including vitamin D, parathyroid hormone and phosphatonins such as fibroblast growth factor-23 (FGF23). Disorders of phosphate homeostasis leading to hypo- and hyperphosphataemia are common and have clinical and biochemical consequences. Notably, recent studies have linked hyperphosphataemia with an increased risk of cardiovascular disease. This review outlines the recent advances in the understanding of phosphate homeostasis and describes the causes, investigation and management of hypo- and hyperphosphataemia. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Crawford S.,University of Glasgow |
Whitnall L.,NHS Lanarkshire |
Robertson J.,NHS Greater Glasgow and Clyde |
Evans J.J.,University of Glasgow
International Journal of Geriatric Psychiatry | Year: 2012
Objectives To review the evidence relating to the diagnostic accuracy and clinical utility of the Addenbrooke's Cognitive Examination (ACE) and its updated version, the Addenbrooke's Cognitive Examination-Revised (ACE-R) in relation to the diagnosis of dementia. Design A systematic search of relevant databases was conducted, covering the period 2000 to April 2010. Specific journals and reference lists were hand searched. Identified studies that fulfilled the inclusion criteria were reviewed using a tailored, methodological quality rating checklist. Results The systematic search process identified nine studies for review (seven relating to the ACE, two on the ACE-R). Strengths and weaknesses across studies are considered, and diagnostic accuracy measures are presented for six out of the nine studies. Conclusion The evidence suggests that the ACE/ACE-R is capable of providing information on a range of cognitive domains and of differentiating well between those with and those without cognitive impairment. Further research examining how the tools distinguish between dementia subtypes and mild cognitive impairment will further benefit the evidence base. Copyright © 2011 John Wiley & Sons, Ltd.
Sinclair A.,NHS Lanarkshire |
Alexander H.A.,Red Deer Center
Public Health | Year: 2012
Objectives: Mortality from coronary heart disease remains higher in Scotland than the European average. Primary prevention programmes, such as Keep Well, aim to tackle the associated risk factors within deprived communities. In Lanarkshire, the problem of non-attendance amongst 'hard-to-reach' groups was addressed by an outreach team, but there was a need to understand the methods employed to achieve health screening attendance. Study design: Qualitative interviews with a typical sample of those who initially failed to attend for health screening but were subsequently appointed after outreach intervention. Methods: Semi-structured interviews (n=30) were conducted following clinic attendance. Transcripts were subjected to a form of content analysis and concepts were arranged into themes. Results: The group often referred to as 'hard-to-reach' are more accurately defined as either 'hard-to-contact' or 'hard-to-engage'. Non-attenders reported that outreach staff were effective in engaging them partly because of their personalities, but also because some of the contacts occurred at an opportune time. Conclusions: Not all non-attenders for screening appointments are negatively disposed towards health screening, and defining them all as 'hard-to-reach' does them a disservice. The majority appeared to need outreach staff to convert them into attenders, but the costs of this need to be balanced against the benefits realized. © 2011 The Royal Society for Public Health.
Langan J.,NHS Lanarkshire |
Shajahan P.,University of Glasgow
Psychiatrist | Year: 2010
Antipsychotic polypharmacy is an increasingly encountered clinical scenario. This review considers the reasons behind antipsychotic polypharmacy and the patterns of its use. We also consider the evidence of effectiveness of combined therapy v. monotherapy and the rationale behind the potentially beneficial combinations that are used. The potential dangers of antipsychotic polypharmacy are also discussed and the limited research regarding switching from polypharmacy to monotherapy is reviewed. Some provisional recommendations regarding antipsychotic polypharmacy are proposed.
Hill D.,NHS Lanarkshire
Heroin Addiction and Related Clinical Problems | Year: 2016
Introduction: Over time the substances misused in a population changes as does other simple demographics, such as age, number of treatment episodes and treatments. Methods: This article reflects on data obtained from patients engaging or re-engaging with NHS Lanarkshire addiction services to look at these demographics and also ensure that the treatment services offered are still appropriate to the population. Results: The data demonstrates that the population is growing older before they access treatment. The substances being misused are also changing with time. The most common profile for a new patient accessing treatment in NHS Lanarkshire during the data collection period can also be determined. Conclusions: The data shows that NHS Lanarkshire Addictions Services are addressing the issue and offering a choice of opioid agonist treatment to individual patients. © 2015,Pacini Editore S.p.A.. All rights reserved.
Duffy K.,NHS Lanarkshire
Journal of Practice Teaching and Learning | Year: 2013
Within pre-registration nursing education programmes, clinical competence is verified via continuous assessment in practice. Registered nurses who have undertaken mentor preparation assess competence in practice and have a responsibility to confirm that nursing students are capable of safe and effective practice prior to registration. This requires mentors to identify underperforming students and manage the situation appropriately. Drawing on interview data from 10 mentors who had failed a student in practice this paper will highlight the processes, alongside, the difficulties and dilemmas associated with managing a failed assessment successfully. Three key concepts emerging from the data will provide the framework for this paper, namely: identifying the weak student; creating possibilities for success; deciding to fail.Within the concept of 'Identifying the weak student' participants discuss how they recognised the early indicators of possible failure. While, 'Creating possibilities for success' reveals the strategies mentors used to attempt to facilitate students' progress. The final concept 'Deciding to fail' exposes the emotional consequences for both the mentor and the student of a failed assessment and the importance of debriefing following the event. The paper concludes by discussing the support needs of mentors as this emerged as crucial in the process of managing a failed assessment.