Chester le Street Community Hospital

The audit reported in this paper and submitted to the Psychiatry of Old Age Management group, assessed six units within each of two health districts in the UK. Using a nonparticipatory observation method in the units selected, the aim was to measure quality and the environment of care. Dependency levels of the clients/residents were also estimated to give a clearer picture of the setting and the care requirements. This was intended to establish a baseline for the units mapped and to enable care developments to be focussed upon intended outcomes. Results led to a number of observations related to the levels of interaction between staff and clients/residents, the need for a wider range of activities to promote person-centred care, and a suggested route to the improvement in quality of life for this vulnerable group of people. Assessment of dependency levels linked to the results of the mapping showed that high dependency does not lead automatically to a lower quality of person centred care.

This paper addresses the concept of person-centred care for people with dementia by consideration of an audit process using dementia care mapping as the audit tool. It is argued that this tool is best for identifying the lived experiences of the people in receipt of care. As a result it is able to identify the overall culture of care and its level of 'person-centred' approach. The audit was conducted on 12 units, half of which were day units and the others catering for inpatients. Five patients were mapped on each day for a 4-day period. The results give some idea of the quality of care and identify where improvement is necessary. Scores such as well-being values and the Dementia Care Index give clear signposts to the level of person-centred care and highlight where staff development is necessary. Recommendations are given to aid on-going planning.

OBJECTIVES: Mineralisation of the tendon of the supraspinatus muscle has been reported as a common finding in dogs with thoracic limb lameness. It is not clear if the mineralisation is a clinically significant cause, or a secondary effect, of lameness. The aim of this retrospective study was to determine the prevalence of mineralisation of the tendon of the supraspinatus muscle in dogs presented to the clinic for reasons other than lameness and where lameness was not evident at the time of presentation. MATERIALS AND METHODS: Dogs undergoing CT of the thorax were identified from the clinical records. The dogs selected were those presented for clinical issues other than lameness and with no history of lameness. The CT scans were screened to identify the presence or otherwise of supraspinatus mineralisation. Signalment was recorded on all the cases. RESULTS: Supraspinatus mineralisation was detected in four out of 99 dogs (4%) with all four cases found in male dogs. Medium to large breed dogs were most frequently affected, with a mean age of 9 years. Unilateral mineralisation of the left thoracic limb only was identified. CLINICAL SIGNIFICANCE: The prevalence of supraspinatus mineralisation was low in this population of non-lame dogs. This low level when compared to the higher prevalence level found in lame dogs, suggests that supraspinatus mineralisation could be associated with lameness in dogs either as an indirect result of lameness or as a primary cause.

FOR NURSE specialists seeking to extend their knowledge of obesity this text provides a broad and accessible account of obesity as a multidimensional health issue in the context of, for example, diabetes, cardiovascular disease or child health. There are detailed sections for more advanced understanding.

We describe the coproduction, pilot implementation, and user evaluation of an evidence‐based training intervention addressing prevention of Sudden Unexpected Deaths in Infancy (SUDI) for the multiagency workforce supporting vulnerable families with babies in a northern English county. We aimed in this pilot study to improve knowledge, skills, and engagement of professionals and support staff providing services for vulnerable families with increased risk of SUDI. The training intervention was co‐produced by the academic team and the project Steering Committee which comprised senior leaders from the local authority, health and care sectors, and third‐sector organisations, and rolled out to multiagency teams between November 2022 and March 2023. Evaluation data were collected using a post‐training questionnaire, followed up by the Normalisation Process Theory (NPT) NoMAD survey issued at two time‐points post‐training, and interviews with stakeholders. The evaluation, conducted from January to May 2023, aimed to assess how well the multiagency workforce accepted SUDI prevention as part of their remit and incorporated SUDI prevention activities into their everyday work. Most multiagency professionals and support staff were enthusiastic about the training and their role in SUDI prevention. Fewer health professionals completed the training than expected. Forty percent (397/993) of invited staff completed the training. Our results revealed initial lack of knowledge and confidence around SUDI prevention and targeted provision for vulnerable families which improved following the Eyes on the Baby training. The proportion of nonhealth professionals rating their knowledge of SUDI prevention as good or excellent increased significantly from 28% before training to 57% afterwards. Self‐rated confidence in discussing SUDI prevention with families increased significantly from 71% to 97%. Health professionals’ ratings increased significantly for knowledge from 62% to 96%, and confidence from 85% to 100%. Use of NPT allowed us to identify that by the time of evaluation, the earliest adopters were cognitively involved with the programme and engaged in collective action, while later adopters had not yet reached this stage. We conclude that effective implementation of multiagency working for SUDI prevention can be accomplished by providing clear training and guidance for all staff who have regular or opportunistic contact with vulnerable families. Our next step is to evaluate the sustainability of MAW SUDI prevention over the medium to long term and assess the responses of recipient families to this approach.

Religious fundamentalists, or creationists as they are sometimes called, are strongly opposed to the current scientific theory of evolution, which holds that modem man arose through the slow process of development from a line of archaic hominids. On the other hand, modem scientists dismiss the arguments of the creationists, who believe in a very young Earth rather than the current geological model, and who believe that the Genesis story is the unerring word of God (Fry, 1983). Many individuals do not have a strong conviction as to which version to believe, but nevertheless they feel threatened by the scientific version because it does not posit a God in the creative process. Most Americans who claim to be born-again Christians believe in the Bible's account of creation (Newell, 1982). The result of this dilemma is that most individuals pay homage to the technological aspect of science as it affects their daily lives, but on certain days they also pay homage to an anthropomorphic God they may not understand but nevertheless fear. It is my contention that recent discoveries point to a resolution of this seemingly intractable conflict. The solution to reconciling the views of the creationist and the evolutionist lies in the interpretation of two historic occurrences, one of recent origin and the other from remote antiquity. An examination of modem discoveries, both archeological and biological, along with a new interpretation of certain ancient mythologies,