Effects of intensive lifestyle changes on the progression of mild cognitive impairment or early dementia due to Alzheimer's disease: a randomized, controlled clinical trial.

Background: Evidence links lifestyle factors with Alzheimer's disease (AD). We report the first randomized, controlled clinical trial to determine if intensive lifestyle changes may beneficially affect the progression of mild cognitive impairment (MCI) or early dementia due to AD.

Methods: A 1:1 multicenter randomized controlled phase 2 trial, ages 45-90 with MCI or early dementia due to AD and a Montreal Cognitive Assessment (MoCA) score of 18 or higher.

Initiatives aimed at retaining ethnically diverse student nurses in undergraduate programmes: An integrative review.

Aims And Objectives: To identify initiatives aimed at retaining ethnically diverse students in Bachelor/Baccalaureate undergraduate nursing programmes. The review focused on identifying strategies attempting to address this issue.

Background: There is a recognised shortage of ethnically diverse registered nurses (RN) worldwide.

Time to Improve Informed Consent for Dialysis: An International Perspective.

The literature reveals that current nephrology practice in obtaining informed consent for dialysis falls short of ethical and legal requirements. Meeting these requirements represents a significant challenge, especially because the benefits and risks of dialysis have shifted significantly with the growing number of older, comorbid patients. The importance of informed consent for dialysis is heightened by several concerns, including: () the proportion of predialysis patients and patients on dialysis who lack capacity in decision making and () whether older, comorbid, and frail patients understand their poor prognosis and the full implications to their independence and functional status of being on dialysis.

Improving nephrology service delivery - Accessing the specialist.

Background: The increased prevalence of chronic kidney disease (CKD) is straining the medical workforce and healthcare budget. To improve efficiency, patients require streamlined access to renal and general practice specialist advice.

Objective: The aim of this article is to profile general practitioner (GP) referrals for patients with CKD and compare these referrals to national guidelines.

NURSES' BEREAVEMENT NEEDS AND ATTITUDES TOWARDS PATIENT DEATH: A QUALITATIVE DESCRIPTIVE STUDY OF NURSES IN A DIALYSIS UNIT.

Background: Dialysis nurses have a unique relationship with their patients and often require bereavement support should a patient death occur. This study was conducted in 2014 and aimed to explore the attitudes of dialysis nurses to death and dying and to identify suitable bereavement strategies following a death of a patient.

Methods: A purposeful, convenience sample of all nurses employed in the dialysis service completed a demographic profile and The Death Attitudes Profile Revisited (DAP_R) survey.

Enhancing rigour in the validation of patient reported outcome measures (PROMs): bridging linguistic and psychometric testing.

Background: A strong consensus exists for a systematic approach to linguistic validation of patient reported outcome measures (PROMs) and discrete methods for assessing their psychometric properties. Despite the need for robust evidence of the appropriateness of measures, transition from linguistic to psychometric validation is poorly documented or evidenced. This paper demonstrates the importance of linking linguistic and psychometric testing through a purposeful stage which bridges the gap between translation and large-scale validation.

Innovations aimed at improving the physical health of the seriously mentally ill: an integrative review.

Aims And Objectives: The aim of this paper is to report an integrative review of the literature that focused on innovations aimed at enhancing the physical health of people with serious mental illness.

Background: Despite the abundance of literature that highlights the relationship between serious mental illness and physical ill health, the provision of physical health care for the seriously mental ill remains a challenge. Many different strategies have been developed, which endeavour to address the poor physical health of people with serious mental illness.

The physical health of the seriously mentally ill: an overview of the literature.

Despite the wealth of literature which attests to the relationship between serious mental illness (SMI) and physical ill health, the provision of optimum physical health care for mental health service users remains a challenge. In England the Department of Health has identified the evident health inequalities for people with SMI as a priority area for health improvement, publishing numerous policy directives aimed at addressing these inequalities. However, this is a highly complex process and little is known about why the rhetoric of holistic health care has proved unattainable thus far.

Improving evidence-based care for patients with pyrexia.

Fever or pyrexia is a common clinical condition which nurses treat regularly. Fever and hyperpyrexia are defined in this article with a physiological explanation for this adaptive response. Suppression of temperature elevation prevents the production of antibodies and inhibits cell repair.

The role of midwives and health visitors in promoting intergenerational language maintenance in the bilingual setting: perceptions of parents and health professionals.

Aims And Objectives: The increasing status and regard of indigenous minority languages across Europe, means the advantages of bilingualism for individuals and communities are now well established. We set out to elicit parents' and health professionals' views of the role of health visitors and midwives in promoting bilingualism in the family and to consider whether health professionals acknowledge the contribution that bilingualism makes to public health.

Background: A three-year study was completed to measure the impact of a language transmission initiative which depends on the input of midwives and health visitors with new parents and how its effect could be improved.

Magnetic resonance imaging of brain injury in the high-risk term infant.

Magnetic resonance imaging (MRI) is noninvasive and nonionizing and offers excellent soft-tissue contrast and good spatial resolution, providing anatomical detail that cannot be obtained by any other imaging modality. In this review, we discuss the imaging findings in perinatal arterial stroke, hypoxic ischemic encephalopathy, metabolic abnormalities, and infection. Conventional imaging can detect patterns of injury that relate to the etiology and timing of an insult and provide valuable information about prognosis.

Identifying priorities for establishing bilingual provision in nurse education: a scoping study.

Research evidence demonstrates that offering language choice to patients enhances the quality of healthcare provision. This has implications for the preparation of nurses for practice in bilingual settings, where legislation often leads to demands for health services in both languages and bilingual competence amongst healthcare providers. This paper reports on a scoping study of bilingual provision in nurse education in the bilingual context of Wales, UK, as a means of informing the evidence base for national strategic planning.

A randomized, clinical trial to compare endoscopic sphincterotomy and subsequent laparoscopic cholecystectomy with primary laparoscopic bile duct exploration during cholecystectomy in higher risk patients with choledocholithiasis.

Introduction: Outcomes after endoscopic sphincterotomy (ES) and subsequent laparoscopic cholecystectomy (LC) versus laparoscopic bile duct exploration (LBDE) during LC are comparable in fit patients with choledocholithiasis. This randomized, clinical trial aimed to determine the optimum treatment in patients with higher medical risk.

Materials And Methods: Ninety-one higher risk patients with evidence of bile duct stones were randomized to ES/LC (group A) or LBDE during LC (group B).

Inconsistent use of the critical incident technique in nursing research.

Aim: This paper is a critique of the use of critical incident technique in nursing and a demonstration of how its development has resulted in inconsistency and confusion.

Background: Critical incident technique is used globally by nurse researchers to explore a plethora of nursing issues. Its main strengths are flexibility and adaptability, but its popularity has resulted in ambiguity and confusion.

Research awareness: making learning relevant for pre-registration nursing students.

This paper outlines efforts to improve the teaching and learning methods for research on a second year pre-registration nursing programme in one university in Wales, UK. This focussed on experiential approaches supported by electronic learning resources. A subsequent evaluation aimed to elicit participating students' and lecturers' perceptions of the success of the experiential approaches and the supporting resources.

Using the critical incident technique to explore student nurses' perceptions of language awareness.

Current evidence demonstrates that language awareness in nursing contributes to high quality patient care. Although language awareness amongst qualified nurses has been considered, there is a dearth of literature that examines how student nurses respond to language sensitivity in the healthcare setting. The critical incident technique was used to elicit the perceptions of student nurses regarding language awareness.

Spontaneous passage of bile duct stones: frequency of occurrence and relation to clinical presentation.

Background: Little is known about the spontaneous passage of bile duct stones. The aim of this study was to determine the rate of spontaneous stone passage and relate it to the clinical presentation of the bile duct stone.

Patients And Methods: Prospectively collected data were studied on a total of 1000 consecutive patients undergoing laparoscopic cholecystectomy with or without laparoscopic common duct exploration.

A prospective single-blinded controlled study comparing laparoscopic ultrasound of the common bile duct with operative cholangiography.

Background: Ultrasound examination of the bile duct during cholecystectomy compares well with operative cholangiography. Studies so for have not been blinded, nor has the stone content been validated immediately. We have, therefore, carried out a blinded comparison of laparoscopic ultrasound with fluoroscopic operative cholangiography.

All-comers policy for laparoscopic exploration of the common bile duct.

Background: Laparoscopic exploration of the common bile duct is associated with substantial variation in results suggesting that different patient populations are being reported. This report observes the results in a defined population and on an intention-to-treat basis.

Methods: All patients with suspected bile duct stones who were fit for surgery from April 1994 were offered laparoscopic bile duct exploration.

Comparison of endoscopic sphincterotomy and laparoscopic exploration of the common bile duct.

Background: Laparoscopic exploration of the common bile duct is becoming more popular, although endoscopic sphincterotomy remains the usual treatment for bile duct stones. However, loss of the biliary sphincter causes permanent duodenobiliary reflux, and recurrent stone disease and biliary neoplasia may be a consequence.

Methods: A systematic literature review was conducted to compare laparoscopic exploration with endoscopic sphincterotomy.

Brushing has made a sweeping change: use of the endoluminal FAS brush in haemodialysis central venous catheter management.

Common usage of central venous catheter (CVC) access for haemodialysis has presented the haemodialysis nurse with the challenge of maintaining CVCs as a viable form of access. The major complications seen with CVC use are obstruction and infection. A project was undertaken to identify the usefulness of the endoluminal fibrin analysis system (FAS) brush as an intervention in haemodialysis CVC management.

Potential of laparoscopic ultrasonography as an alternative to operative cholangiography in the detection of bile duct stones.

Background: Intraoperative cholangiography (IOC) is time consuming, requires radiation and sometimes fails. In contrast, laparoscopic ultrasonography (LUS) is a comparatively quick, safe and non-invasive technique. The aim of this study was to assess the potential of LUS as an alternative to IOC.