Bates D.,Royal Infirmary |
Bates C.,Northumbria Healthcare NHS Trust
Medicine (United Kingdom) | Year: 2013
Confusion and delirium are the most common behavioural disorders seen in an acute medical or surgical unit. Confusion can be regarded as a mild form of delirium and may give warning of the development of the more severe disorder. It causes an acute change of mental status, characterized by abnormal and fluctuating attention. It affects between 10 and 30% of medically ill patients, especially the elderly and often shortly after admission to hospital. It causes prolonged admission, increased morbidity and mortality, and delayed discharge, often culminating in long-term care. Its causation is reviewed and its prevention and management are described. © 2013 Elsevier B.V. All rights reserved.
Lecouturier J.,Newcastle University |
Cunningham B.,Corbridge Medical Group |
Campbell D.,Northumbria Healthcare NHS Trust |
Copeland R.,Northumbria Healthcare NHS Trust
British Journal of General Practice | Year: 2011
Background: Despite the rapid rise in the use of multicompartmental compliance aids (MCAs), little is known about the role they play in self-management of medication. Aim: To explore the perceived benefits of MCAs for people using them to manage their own or a relative's medication. Design of study: Qualitative study using in-depth interviews. Setting: West Northumberland. Method: Recruitment was via posters and leaflets in general practices and community pharmacies. In-depth interviews were conducted using a topic guide. Results: Nineteen people were interviewed. Three overarching themes emerged in relation to medicine taking: disruption, organisation, and adherence, which impacted on control. The medication regime had caused disruption to their lives and this had led to the purchase of an MCA. The MCA enabled them to organise their medication, which they believed had improved the efficiency of medicine taking and saved time. Although the MCA did not prompt them to take their medication, they could see whether they had actually taken it or not, which alleviated their anxiety. To meet their individual needs and lifestyles, some had developed broader systems of medication management, incorporating the MCA. For a small cost - the initial outlay for the MCA and time spent loading it - they gained control over the management of their medication and their condition. Conclusion: This group found the use of an MCA to be beneficial, but advice and support regarding how best to manage their medication and on the most appropriate design to suit their needs would be helpful. ©British Journal of General Practice.
Cloke D.J.,Northumbria Healthcare NHS Trust |
Cloke D.J.,University of Bath |
Ansell P.,Northumbria University |
Avery P.,Northumbria University |
Deehan D.,Freeman Hospital
British Journal of Sports Medicine | Year: 2011
Background Injuries are common in youth soccer, of which ankle injuries form a significant proportion. However, there is a lack of prospective data on the epidemiology and nature of these injuries. Aim To prospectively study the incidence of ankle injuries in three Football Association (FA) academies, with particular emphasis on severe injuries and factors associated with increased injury rate. Design Descriptive epidemiology study. Methods All 419 players within three FA youth academies during the 2007-2008 season were included, between under 9 and under 18 age groups. Ankle injuries causing a loss of more than 48 h training were studied, along with the setting and mechanism of injury, the diagnosis, time to rehabilitate, any investigations and surgical treatment. The incidence of injury per 1000 h exposure in match, training and in total was calculated. Results A total of 56 (incidence 14%) new ankle injuries were identified during this 1-year study period. Twenty-six (46%) of these occurred in competition, 24 (43%) were by contact, and eight (14%) had a severe injury diagnosed. The incidence was higher in the competitive setting. Ten injuries (18%) missed more than 6 weeks' training. Of these, seven were diagnosed as 'sprain' or 'strain,' of whom only three had been further investigated. There was a significant relationship between injury incidence and age group for total and match exposure, but not for training exposure. Conclusions The incidence of ankle injury in youth soccer is higher in competition, and increases with age in competition. 17.5% of ankle injuries missed more than 6 weeks' training, but the authors found a subgroup of players with delay in returning to sport in whom there was no further investigation to establish the diagnosis. This group may harbour occult injury to the chondral surfaces, and earlier investigation could minimise secondary joint damage in this 'at risk' age group.
Reed M.,Northumbria Healthcare NHS Trust |
Kimberger O.,Medical University of Vienna |
McGovern P.D.,Medway Maritime Hospital |
Albrecht M.C.,Augustine Temperature Management
AANA Journal | Year: 2013
Forced-air warming devices are effective for the prevention of surgical hypothermia. However, these devices intake nonsterile floor-level air, and it is unknown whether they have adequate filtration measures to prevent the internal buildup or emission of microbial contaminants. We rated the intake filtration efficiency of a popular current-generation forced-air warming device (Bair Hugger model 750, Arizant Healthcare) using a monodisperse sodium chloride aerosol in the laboratory. We further sampled 23 forced-air warming devices (same model) in daily hospital use for internal microbial buildup and airborne-contamination emissions via swabbingand particle counting. Laboratory testing found the intake filter to be 63.8% efficient. Swabbing detected microorganisms within 100% of the forcedair warming blowers sampled, with isolates of coagulase- negative staphylococci, mold, and micrococci identified. Particle counting showed 96% of forced-air warming blowers to be emitting significant levels of internally generated airborne contaminants out of thehose end. These findings highlight the need for upgraded intake filtration, preferably high-efficiency particulate air filtration (99.97% efficient), on currentgeneration forced-air warming devices to reduce contamination buildup and emission risks.
Day A.M.,Northumbria Healthcare NHS Trust |
James I.A.,Tyne and Wear NHS Foundation Trust |
Meyer T.D.,Northumbria University |
Lee D.R.,Northumbria University
Aging and Mental Health | Year: 2011
Objectives: Research suggests that the use of lies and deception are prevalent in dementia care settings. This issue has been explored from the view point of carers and professionals, and the acceptability and ethicality of deception in dementia care remains an area of heated debate. This article explored the issue of lies and deception in dementia care from the unique perspective of the people being lied to: People with Dementia. Method: This study used a qualitative methodology, specifically, Grounded Theory (GT). The study used a two-phased design. Phase one involved a series of one-to-one interviews with People with Dementia. During phase two, the participants were re-interviewed in order to develop the emerging theory. Results: Lies were considered to be acceptable if told in People with Dementia's best interest. This best interest decision was complex, and influenced by factors such as the person with dementia's awareness of the lie, and the carer's motivation for lying. A model depicting these factors is discussed. Conclusion: This study enables the perspective of People with Dementia to be considered, therefore providing a more complete understanding of the use of deceptive practices in dementia care settings. This study suggests that the use of lies and deception in dementia care warrants further investigation. © 2011 Taylor & Francis.
Russell M.,Wansbeck Hospital |
Raheja V.,Wansbeck Hospital |
Jaiyesimi R.,Northumbria Healthcare NHS Trust
Perspectives in Public Health | Year: 2013
Cervical cancer is the third most common female cancer worldwide. It remains the highest ranking preventable cancer affecting women in developing countries. Cervical cancer is caused by sexual transmission of human papillomavirus (HPV). It is estimated that more than 80% of sexually active women will be infected with HPV in their lifetime, usually in their mid to late teens, 20s and early 30s. Persistence of high-risk oncogenic subtypes can lead to the development of precancerous change (cervical intraepithelial neoplasia (CIN)), which can ultimately lead to cervical cancer. Progression from CIN to cancer is slow in most cases, and it is believed that progression from CIN 3 to cancer at 10, 20 and 30 years is 16%, 25% and 31.3%, respectively. The cervical screening programme has been successful in reducing the incidence of cervical cancer by recognising early precancerous changes and treating them. A promising advance in women's health has been the development of a vaccine targeting high-risk oncogenic subtypes 16 and 18, which are responsible for 70% of all cervical cancers. Two HPV vaccines are available: Merck & Co.'s Gardasil® and GlaxoSmithKline's Cervarix®. The aim of this programme is to provide three doses prior to sexual debut with the hope that it will reduce the rates of cervical cancer in the future. Women who are already sexually active can still be vaccinated, but, the vaccine has been shown to be less effective in them. Uptake remains a challenge for public health, and efforts should focus on educating parents about the association between HPV and cervical cancer. Routine vaccination of young men is a debatable issue and has been found to be less cost-effective, as the burden of disease such as anal and penile cancers in males is less than cervical cancers in women. Current evidence suggests that the HPV vaccination programme should focus on increasing and maintaining high coverage of vaccination in girls. There may, however, be some benefit in vaccinating young men in areas where the uptake of vaccination in women in less than 70%. A school-based vaccination programme has been shown to be effective, with an uptake rate in England of 76% for 2009/2010, but this has implications for the role of school nurses in the delivery of other services. This article explores the health benefits of the HPV vaccine, the impact of attitudes, cost-effectiveness and the involvement of school nurses in programme delivery. Copyright © 2013 Royal Society for Public Health.
Jameson S.S.,Northumbria Healthcare NHS Trust |
Jameson S.S.,Southern General Hospital |
Bottle A.,Northumbria Healthcare NHS Trust |
Bottle A.,Jarvis |
And 6 more authors.
Journal of Bone and Joint Surgery - Series B | Year: 2010
The National Institute for Clinical Excellence (NICE) produces recommendations on appropriate treatment within the National Health Service (NHS) in England and Wales. The NICE guidelines on prophylaxis for venous thromboembolism in orthopaedic surgery recommend that all patients be offered a low molecular weight heparin (LMWH). The linked hospital episode statistics of 219 602 patients were examined to determine the rates of complications following lower limb arthroplasty for the 12-month periods prior to and following the publication of these guidelines. These were compared with data from the National Joint Registry (England and Wales) regarding the use of LMWH during the same periods. There was a significant increase in the reported use of LMWH (59.5% to 67.6%, p < 0.001) following the publication of the guidelines. However, the 90-day venous thromboembolism events actually increased slightly following total hip replacement (THR, 1.69% to 1.84%, p = 0.06) and remained unchanged following total knee replacement (TKR, 1.99% to 2.04%). Return to theatre in the first 30 days for infection did not show significant changes. There was an increase in the number of patients diagnosed with thrombocytopenia, which was significant following THR (0.11% to 0.16%, p = 0.04). The recommendations from NICE are based on predicted reductions in venous thromboembolism events, reducing morbidity, mortality and costs to the NHS. The early results in orthopaedic patients do not support these predictions, but do show an increase in complications. ©2010 British Editorial Society of Bone and Joint Surgery.
Lie M.L.S.,Northumbria University |
Hayes L.,Northumbria University |
Lewis-Barned N.J.,Northumbria Healthcare NHS Trust |
May C.,University of Southampton |
And 2 more authors.
Diabetic Medicine | Year: 2013
Aims: To explore factors influencing post-natal health behaviours following the experience of gestational diabetes, and to elicit women's views about the feasibility of lifestyle intervention to prevent diabetes during the first 2 years after childbirth. Methods: Qualitative study using semi-structured interviews with women who had gestational diabetes. In phase 1 (31 women), interviews explored the experience of gestational diabetes, ideas about future risk of diabetes and factors influencing post-natal health-related behaviours. Statements were developed summarizing women's views of lifestyle change to prevent diabetes. In phase 2 (14 women), interviews explored how the passage of time had contributed to changes in health behaviour, and the statements were used to develop views about diabetes interventions. Results: Women were aware of their risk of developing diabetes, but did not always act on such knowledge. Pregnancy motivated behaviour changes to benefit the unborn child, but after delivery these changes were often not maintained. Tiredness, maternal attachment and childcare demands were prominent barriers in the early post-natal months. Later, work, family and child development became more significant barriers. Many women became more receptive to healthy eating messages around the time of weaning. Women were positive about long-term support for self-management to reduce their diabetes risk. Conclusions: There is potential to reduce the risk of Type 2 diabetes post-natally among women with gestational diabetes. Interventions need to be developed that take into account contextual factors and competing demands, are flexible and respond to women's individual circumstances. Randomized trials of such interventions are warranted. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.
Abraham A.M.,Northumbria Healthcare NHS Trust |
Abraham A.M.,Northumbria University |
Pearce M.S.,Northumbria University |
Mann K.D.,Northumbria University |
And 3 more authors.
BMC Musculoskeletal Disorders | Year: 2014
Background: Musculoskeletal ultrasound has been found to be more sensitive than radiographs in detecting osteophytes. Our objective was to measure the prevalence of features of osteoarthritis (OA), in the dominant hand, knees and hips using ultrasound, within the Newcastle Thousand Families birth cohort. Methods. Participants were aged 61-63 (mean 63) years. Knee images were scored for presence of osteophytes and effusion. Hip images were scored for the presence of osteophytes and femoral head abnormality. The first carpometacarpal joint, metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of the index finger (dominant hand) were imaged for osteophytes. Results: Among 311 participants, prevalence of osteophytes at the distal interphalangeal joint was 70% while it was 23%, 10% and 41% for index proximal interphalangeal and metacarpophalangeal and thumb base carpometacarpal joints respectively. Prevalence of knee osteophytes was 30%, hip OA was 41%. Prevalence of knee effusions was 24% (right) and 20% (left). Ultrasound evidence of generalised OA (48%) and isolated hand OA (31%) was common, compared to isolated hip or knee OA (5%) and both hip and knee OA (3%). Conclusion: This is the first study to assess prevalence of ultrasound features of OA in a population-based sample. The higher prevalence of hand/hip OA, when compared to previous radiographic studies, supports the hypothesis that ultrasound is more sensitive than radiography in detecting OA, particularly for osteophytes. © 2014 Abraham et al.; licensee BioMed Central Ltd.
Allen J.,Northumbria Healthcare NHS Trust |
Williamson S.,Northumbria Healthcare NHS Trust
International Journal of Clinical Pharmacy | Year: 2014
Case: A case study of a patient who over complied with adjuvant capecitabine monotherapy on several occasions is described. The patient suffered worsening side effects, predominantly palmar plantar erythrodysesthesia which resulted in dose reduction and delay. The patient had disregarded advice to stop taking the capecitabine as he perceived it as "important to fight his cancer". The patient refused review with a psychologist. Conclusion: There is a lack of evidence regarding the issue of over compliance. Pharmacists should consider discussing patient's attitudes towards taking their medication and its importance to them in treating their cancer. Tools that are used to assess non-compliance could be utilised to identify patients who over comply. Further research is required to gain further understanding of the psychological factors behind patient's decisions to over comply with treatment. © 2014 Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie.