Miriam McMullan

Research Ethics in the UK: What Can Sociology Learn from Health?

The article reviews ethical consideration in social research and identifies current approaches to safeguarding ethical standards. One of these is the requirement to obtain approval from research ethics committees (RECs). Based on the results of a survey of UK social science academics about the process of applying to National Health Service RECs, we conclude that lessons can be learned for Sociology from the experiences of social researchers in Health. Overly rigid ethics committees could be counter-productive; we may need to reassess the functions of RECs and to strengthen other procedures to ensure the highest ethical standards for Sociology. Some suggestions for how this might be done are taken from the literature in the hope that they will stimulate debate.

Managing serum phosphate in haemodialysis patients: time for an innovative approach?

Background/Objectives:Hyperphosphataemia, a common biochemical abnormality in chronic kidney disease, poses significant management challenges. This study aims to determine whether the reasons for this are multifactorial; including poor dietary knowledge, poor adherence to a low phosphate diet and phosphate-binding medications and the impact of age on these parameters.Subjects/Methods:In order to compare serum phosphate and other associated parameters to the UK Renal Association Clinical Practice Guidelines 2010 an audit and service evaluation questionnaire was carried out in May 2011 on 130 haemodialysis outpatients attending the Plymouth Dialysis Unit.Results:Fifty-three percent of patients had serum phosphate within the target range of 1.1–1.7 mmol/l, 77% and 85% had serum calcium and parathyroid hormone within target ranges, respectively. Younger patients (18–45years) were significantly less likely to have serum phosphate within range χ2 (2, n=124)=18.77, P<0.001. Despite better knowledge of their own phosphate levels (P=0.005), phosphorus-rich foods (P<0.001), symptoms of hyperphosphataemia (P<0.001) and increased use of Renal Patient View (P=0.002), <65 years old had significantly higher phosphate levels than those >65 years (P<0.001). No significant associations were found between phosphate control and the following factors: gender, timing of dialysis shift, years on dialysis or dialysis adequacy.Conclusions:In this population, despite better knowledge, younger patients have worse phosphate control than older patients. Using the same dietary education techniques may not be suitable for all ages, more innovative approaches supported by skilled health professionals are needed to motivate and engage with younger patients to promote self-management and adherence.

The portfolio is your key to self-development.

The Nursing and Midwifery Council requires all registered nurses to maintain a portfolio to record their post-registration education and practice (PREP). At its most basic, a portfolio is a collection of evidence. In nursing education, however, a portfolio represents a dynamic record of learning, progress and achievement. Developing a portfolio can be a catalyst for students’ professional and personal growth, particularly through the process of reflective practice and critical analysis of the evidence you provide. The process of developing the portfolio can lead to an awareness of your own skills, strengths and limitations. Your portfolio will encourage you to develop self-reflection, to take charge of your lifelong learning and help prepare you for post-registration practice. As information is accumulated, portfolios will boost your self-esteem and confidence. Through reflection you will be able to identify gaps in your knowledge, skills and competence, and reconfirm your strengths. Here are some tips to remember: Your portfolio should include details of your assignments, learning activities such as seminars, workshops, online discussions and a reflection on your placements, with a rationale for including these items. It is important the portfolio shows how critical reflection on its contents demonstrates learning. Too much information can create an unwieldy collection of documents; too streamlined a portfolio can become a sterile exercise. Reflecting on your achievements might sound daunting at first but there are many reflective models available (see article opposite). Finally, developing a portfolio can be time consuming, so it is important to prevent the portfolio from becoming a last-minute effort. Although many nursing students feel unsure about developing a portfolio, it should be seen as a journey of personal and professional development. Most students are proud of the learning they have achieved on completion of their portfolio NS

Reply to 'Management of mineral metabolism in haemodialysis patients: need for new strategies|[rsquo]|

We would like to thank Esposito et al. for their comments and interest shown in our study. We read with interest the similar findings of their multicentre study, although we acknowledge that there were some fundamental differences in design. Phosphate control was inversely correlated with age, and younger patients had significantly higher phosphate levels and a lower level of compliance, although we note that this knowledge does not appear to have been assessed. However, there were some differences in the findings between their study and ours. An inverse association between phosphate and adequacy (spkt/v) was found and levels of biochemical indicators were not related to diabetes in their study. Our study found no relationship between adequacy and phosphate control; however, the groups in our study may not have been large enough to demonstrate significance. In our study, we found that patients with diabetes were more likely to have well-controlled phosphate levels, but this difference may have been due to the older age of the diabetic patients rather than diabetes per se. Their findings provide further evidence that compliance is the key to managing renal bone disease. We must not assume that this is an unavoidable condition in our patients but strive to seek further strategies to improve compliance.

Student life - Get a head for maths: Miriam McMullan compares drug calculation skills in students and qualified nurses, with surprising results

One of the most common and responsible tasks for nurses is the administration of medication. Several skills are needed to do this safely, not least the ability to calculate drug dosages accurately.