Limb-specific autonomic dysfunction in complex regional pain syndrome modulated by wearing prism glasses.

In unilateral upper-limb complex regional pain syndrome (CRPS), the temperature of the hands is modulated by where the arms are located relative to the body midline. We hypothesized that this effect depends on the perceived location of the hands, not on their actual location, nor on their anatomical alignment. In 2 separate cross-sectional randomized experiments, 10 (6 female) unilateral CRPS patients wore prism glasses that laterally shifted the visual field by 20°.

Perceptual bias in pain: a switch looks closer when it will relieve pain than when it won't.

Pain is fundamental to survival, as are our perceptions of the environment. It is often assumed that we see our world as a read-out of the sensory information that we receive; yet despite the same physical makeup of our surroundings, individuals perceive differently. What if we "see" our world differently when we experience pain? Until now, the causal effect of experimental pain on the perception of an external stimulus has not been investigated.

Learning to learn self-regulation in practice: a 2 cohort evaluation.

The transfer of nurse training into higher education following 'Project 2000' dramatically changed the status of student nurses. While the majority received a grant or bursary, students were no longer regarded as belonging to the hospital staffing complement. Elcock et al.

The effect of tactile discrimination training is enhanced when patients watch the reflected image of their unaffected limb during training.

In patients with phantom limb pain or complex regional pain syndrome (CRPS), sensory discrimination training increases tactile acuity, normalises cortical reorganisation and decreases pain. In healthy people, sensory cortical response, and tactile acuity, are greater if the participant looks towards the body part being stimulated. Does this effect enhance tactile training in CRPS patients? Ten patients underwent a 30-min tactile discrimination training session under four conditions (order randomised) in a 2 x 2 design: looking towards or away from the stimulated limb and seeing or not seeing skin.

Learning to learn in practice: An evaluation of a 35-day practice orientation programme.

The Practice Education Support Unit at Thames Valley University is committed to improving the quality of students' practice experience. Recent changes to the delivery of the Pre-Registration nursing curriculum have included the instigation of a 35-day practice orientation programme for students on the common foundation programme. The Brent and Harrow 'Student Experiences Group' developed and facilitated a 35-day programme for the March 2007 cohort within their learning community.

Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain.

Approximately thirty-four percent of people who experience acute low back pain (LBP) will have recurrent episodes. It remains unclear why some people experience recurrences and others do not, but one possible cause is a loss of normal control of the back muscles. We investigated whether the control of the short and long fibres of the deep back muscles was different in people with recurrent unilateral LBP from healthy participants.

I can't find it! Distorted body image and tactile dysfunction in patients with chronic back pain.

The conscious sense of our body, or body image, is often taken for granted, but it is disrupted in many clinical states including complex regional pain syndrome and phantom limb pain. Is the same true for chronic back pain? Body image was assessed, via participant drawings, in six patients with chronic back pain and ten healthy controls. Tactile threshold and two-point discrimination threshold (TPD) were assessed in detail.

What do mentors find difficult?

Aims: (i) To assess whether mentors had a positive or negative attitude towards their role; and (ii) to discover what aspects of the role they found easy or difficult.

Background: The fact that mentorship is an important element in nurse training was recognized by Sir Leonard Peach, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting and the Nursing and Midwifery Council which has recently published new standards to support learning and assessment in practice, which include standards for the preparation of Mentors, to be implemented by September 2007. There are many anecdotal reports of the problems which face mentors, but little firm evidence.

Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain.

Chronic pain is often associated with reduced tactile acuity. A relationship exists between pain intensity, tactile acuity and cortical reorganisation. When pain resolves, tactile function improves and cortical organisation normalises.

The training needs of health care support workers: results of a study of workers and their managers.

Aims And Objectives: This study was designed to assess the training needs of health care support workers. In the past, opinions on the topic have been varied, but were rarely based on empirical evidence.

Design And Methods: The study was designed as a self-report questionnaire survey of health care support workers and their managers in six units in health and social care, using as its basis 32 descriptors from the NHS Knowledge and Skills Framework, levels 1 and 2.

Predicting who will drop out of nursing courses: a machine learning exercise.

Introduction: The concepts of causation and prediction are different, and have different implications for practice. This distinction is applied here to studies of the problem of student attrition (although it is more widely applicable).

Background: Studies of attrition from nursing courses have tended to concentrate on causation, trying, largely unsuccessfully, to elicit what causes drop out.

Using visual illusion to reduce at-level neuropathic pain in paraplegia.

Neuropathic pain after spinal cord injury is not well understood and is difficult to treat. One possible cause is mismatch between motor commands and sensory feedback. This two-part study in five paraplegic patients investigated whether a visual illusion aimed to correct this mismatch reduces pain.

When is it safer to say nothing? Some considerations on biases in sampling.

In nursing research, once one has a solid design, one has still to think about-.a sampling strategy and implementation. Too often, the paraphernalia of inferential statistical reasoning is inappropriately deployed when the achieved sample can in no way be claimed to represent the drawn sample.

An empirically-derived clinical placement evaluation tool: a 3-country study.

We report the development of a brief and simple-to-complete clinical placement evaluation scale. Unlike many previous attempts to develop such tools, the one reported here gives reliable numerical scores with a firm empirical foundation. The scoring correlates well between three European countries: UK, Finland, and Germany.

Reported pain after day surgery: a critical literature review.

Background: Despite technological advancements in anaesthesia and analgesia, reported pain levels after day surgery remains high. Whilst it is unrealistic to expect no pain, the level that constitutes 'acceptable' pain remains unclear because of inconsistencies in reporting. These inconsistencies have resulted from different interpretations of what pain is and the use of different measurement tools.

Postoperative wound blistering: is there a link with dressing usage?

Practitioners on an orthopaedic ward used three different types of dressing on two groups of 100 patients who had undergone hip or knee operations, and compared the number of blisters that resulted. They describe their findings.

Smoking--do vascular surgeons practise what they preach?

Smoking is a major health problem in Great Britain and cigarette consumption is rising. Although there are studies concerning the smoking habits of hospital physicians, nurses and oral and maxillofacial surgeons, little is known about the smoking habits of vascular surgeons and the advice given by them to their patients. A questionnaire survey was conducted involving 422 members of the Vascular Surgical Society of Great Britain and Ireland.

Mortality from ruptured abdominal aortic aneurysm in Wales.

Background: The aim of this study was to identify the incidence of, and mortality in, patients with a ruptured abdominal aortic aneurysm (AAA) reaching hospital alive in Wales.

Methods: Patients who presented with a ruptured AAA between September 1996 and August 1997 were analysed. Data were collected prospectively by an independent body, observing strict confidentiality.

Can feedback be individualised, useful, and economical?

An important, but often neglected, part of any research or audit exercise is the reporting back to participants of the results of that exercise. When feedback is made, it is often of a general, aggregated nature. Considerations of cost and psychological factors usually preclude feedback to individuals.

Applying lexical and semantic analysis to the exploration of free-text data.

A substantial study of primary nursing involving the authors ( 1 , 2 ) generated, in addition to the pre-coded data, a large number of free-text responses. We decided to investigate whether these less structured data could help to categorise and understand the leadership styles of ward sisters in the sample.

Research-based measurement tools in the audit process: issues of use, validity and reliability.

The National Health Service is in a period of extensive reform. Value for money is now a key objective. As a consequence, audit has become a widely used concept and activity.