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    SubjectsOperational Research (3)Psychiatry and Mental health (3)Sort It (3)Clinical Psychology (2)emergency care (2)emergency services (2)Hematology (2)Law (2)pre-hospital care (2)public health (2)View MoreAuthorsKingston, Paul (5)Dobson, Andrew E. (4)Finnegan, Alan (4)Mutahunga, Birungi (4)O'Hara, Jamie (4)Stewart, Alex G. (4)Wilkinson, Ewan (4)Taylor, Louise (3)Angus, Neil (2)Bailey, Jan (2)View MoreTypes
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    Lived experiences of negative symptoms in first-episode psychosis: A qualitative secondary analysis

    Gee, Brioney; Hodgekins, Jo; Lavis, Anna; Notley, Caitlin; Birchwood, Max; Everard, Linda; Freemantle, Nick; Jones, Peter B.; Singh, Swaran P.; Amos, Tim; et al. (Wiley, 2018-03-24)
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    Development and delivery of the trainee nursing associate pilot curriculum.

    Roulston, Christina; Davies, Miriam (2019-04-11)
    This article discusses the recently launched curriculum for nursing associates and the authors' involvement in the development of a medicine management module. This required recognition of the challenges in an ever-changing healthcare environment with, in this instance, limited guidance from the Nursing and Midwifery Council and associated professional organisations and with multiple stakeholders to satisfy. Curriculum development therefore required consideration of the concerns of service users and providers regarding the integration of this new, poorly understood role, its potential effect on skill mix and lack of knowledge regarding proposed regulation.
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    Midwifery and psychological care

    Jones, Alun (Mark Allen Group, 2018-12-02)
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    A Retrospective Cross Sectional Study of the Effectiveness of a Project in Improving Infant Health in Bwindi, South Western Uganda.

    Kamugisha, S. Robert; Dobson, Andrew E.; Stewart, Alex G.; Haven, Nahabwe; Mutahunga, Birungi; Wilkinson, Ewan (2018-10-12)
    Introduction: Low-cost community-based interventions to improve infant health potentially offer an exciting means of progressing toward the Sustainable Development Goals (SDGs). However, the feasibility of such interventions in low-income settings remains unclear. Bwindi Community Hospital (BCH), Uganda implemented a 3-year nurse-led community project to address child-health issues. Nurses supported Community Health Volunteers (CHVs) and visited mothers pre- and/or postnatally to assess and educate mothers and infants. CHVs gathered data and gave basic advice on health and hygiene to mothers. We hypothesized that increased interventions by nurses and CHVs and increased contact with households, would improve health and reduce infant mortality. Methods: This was a retrospective cohort study analyzing routine data of all children born between January 2015 and December 2016. There were three interventions: antenatal nurse visit, postnatal nurse visit and CHV participation. Children received different numbers of interventions. We defined four diverse outcomes: facility-based delivery, immunization completeness, nutritional status, and infant mortality. Odds ratios, adjusted odds ratios, and multivariate logistic regression were used to assess associations between interventions and outcomes. Results: Of the 4,442 children born in 2015 and 2016, 91% were visited by a nurse (81% antenatally and 10% postnatally); 7% lived in villages with a high participating CHV. Households receiving a postnatal visit were more likely to complete immunization (aOR: 1.55, p = 0.016) and have the infant survive (aOR: 1.90, p = 0.05). Children from a hard-to-reach village (no road access) were less likely to be delivered in a health facility (aOR: 0.55, p < 0.001) and less likely to survive in their first year (aOR: 0.69, p = 0.03). Having two or more interventions was associated with a child having all four positive outcomes (aOR 0.78, p = 0.03). Lack of baseline data, a control area, or integrated assessment data limited more detailed evaluation. Conclusion: Visits to mothers after birth, by a nurse to educate and identify child illness, were associated with lower infant mortality and improved infant health as measured by completion of immunizations. Community health interventions could potentially have a greater impact if focused on hard-to-reach areas. Building evaluation into all project designs, whether local or internationally funded, would enable greater learning, and hence better use of resources.
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    Community-Based Health Insurance Increased Health Care Utilization and Reduced Mortality in Children Under-5, Around Bwindi Community Hospital, Uganda Between 2015 and 2017.

    Haven, Nahabwe; Dobson, Andrew E.; Yusuf, Kuule; Kellermann, Scott; Mutahunga, Birungi; Stewart, Alex G.; Wilkinson, Ewan (2018-10-09)
    Introduction: Out-of-pocket fees to pay for health care prevent poor people from accessing health care and drives millions into poverty every year. This obstructs progress toward the World Health Organization goal of universal health care. Community-based health insurance (CBHI) improves access to health care primarily by reducing the financial risk. The association of CBHI with reduced under-5 mortality was apparent in some voluntary schemes. This study evaluated the impact of eQuality Health Bwindi CBHI scheme on health care utilization and under-5 mortality in rural south-western Uganda. Methods: This was a retrospective cross-sectional study using routine electronic data on health insurance status, health care utilization, place of birth, and deaths for children aged under-5 in the catchment area of Bwindi Community Hospital, Uganda between January 2015 and June 2017. Data was extracted from four electronic databases and cross matched. To assess the association with health insurance, we measured the difference between those with and without insurance; in terms of being born in a health facility, outpatient attendance, inpatient admissions, length of stay and mortality. Associations were assessed by Chi-Square tests with p-values < 0.05 and 95% confidence intervals. For variables found to be significant at this level, multivariable logistic regression was done to control for possible confounders. Results: Of the 16,464 children aged under-5 evaluated between January 2015 and June 2017, 10% were insured all of the time 19% were insured for part of the period, and 71% were never insured. Ever having had health insurance reduced the risk of death by 36% [aOR; 0.64, p = 0.009]. While children were insured, they visited outpatients ten times more, and were four times more likely to be admitted. If admitted, they had a significantly shorter length of stay. If mother was uninsured, children were less likely to be born in a health facility [adjusted odds ratio (aOR) 2.82, p < 0.001]. Conclusion: This study demonstrated that voluntary CBHI increased health care utilization and reduced mortality for children under-5. But the scheme required appreciable outside subsidy, which limits its wider application and replicability. While CBHIs can contribute to progress toward Universal Health Care they cannot always be afforded.
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    Being homeless in an unequal society: A qualitative analysis of stories of homeless people

    Mabhala, Mzwandile A. (Oxford University Press (OUP), 2018-11-21)
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    Assistive Technologies and the Carers of People with Dementia

    Bhattacharyya, Sarmishtha; Benbow, Susan M. (IGI Global, 2016-01)
    Assistive technologies have a role in supporting both formal and informal carers of people with dementia, and in maintaining the independence, and quality of life of both people with dementia and their carers. The authors report a narrative review of the use of technological interventions to empower the carers of people with dementia, and relate this to a model of ageing well. They argue that this highlights the importance of empowering and connecting with carers in order to increase their participation and connection in the care of their relative/client; and conclude that both empowerment and connection contribute to maintaining autonomy and well-being of both carers and people with dementia. Technological interventions should not be used as alternatives to connection. The emphasis in practice should be on empowering and connecting with both carers and people with dementia.
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    What’s in a name? Family violence involving older adults

    Benbow, Susan M.; Bhattacharyya, Sharmi; Kingston, Paul (Emerald, 2018-12-10)
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    Nerve agents: a guide for emergency nurses. Part 1.

    McGhee, Stephen; Finnegan, Alan; Angus, Neil; Clochesy, John (2019-03-04)
    Recent incidents in the UK and the alleged chemical attacks in Syria by the Bashar al-Assad regime have brought the subject of chemical weapons back into the public domain. To date these types of event have been relatively rare because terrorist plans to harm large numbers of people have mostly been thwarted. This is the first part of a two-part article on nerve agents. Part one gives an overview of these agents, their historical background and manufacture, and how the agents affect physiology. Part two, which will appear in the next issue, considers the pre-hospital response to the use of nerve agents, including effective triage and decontamination, and in-hospital treatment. [Abstract copyright: ©2019 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.]
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    Responding to nerve agent poisoning: a guide for emergency nurses. Part 2.

    McGhee, Stephen; Finnegan, Alan; Angus, Neil; Clochesy, John Michael (2019-04-16)
    The release of chemical agents can cause loss of life and result in major incidents. Chemical agent-related major incidents require a modified response by emergency services due to the chemicals' transmissibility, lethality, latency and persistence. In general, modifications to casualty flow, triage and treatment are made to reduce transmissibility, and lethality of chemical hazards. This article, the second of a two-part series on nerve agents, describes the adapted response and explains how emergency nurses must be familiar with principles of care including incident and casualty management. [Abstract copyright: © 2019 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.]
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