Staff receiving their certificates Nearly 30 staff from a range of nursing disciplines have recently completed their Care Certificate in north Cumbria. They join the 200 new and existing staff who have completed their care certificate since April 2015 to ensure they keep up to date with best practice. The Care certificate is an agreed set of standards that sets out the knowledge, skills and behaviours expected of specific job roles in the health and social care sector. It is part of newly qualified staff’s induction, is included in many apprenticeships and can also help current staff develop their skills and career pathways. Tina O’Neil a rehabilitation assistant in the Allerdale Community rehabilitation team said “I feel my confidence and skills have grown with the support of my mentor. I would recommend this learning and development to anyone”. Trisha Goldwater, Tina’s mentor and Assistant Practitioner in the rehabilitation team said “I am absolutely proud of the transformation in Tina’s journey and her progression.

Her writing skills have improved to a high level. Her patient skills and knowledge have improved beyond expectation.” Staff can use the learning from the Care Certificate towards some existing qualifications avoiding the need to repeat learning in Jen Connor Trainee assistant practitioner from the Memory Matters team.

She said: “It has improved my confidence to work towards my Assistant Practitioner degree.” Alison Smith, Executive Chief Nurse for North Cumbria University Hospitals and Cumbria Partnership NHS Trusts presented 28 staff with their Care Certificates at a presentation event at Carleton Clinic on 13th December.

Jan 12, 2013 - Presentation Assistant Pro allows users to directly draw and zoom into certain portions for quick screen based presentation, so the.

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• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Stress fractures Ferco Berger, Milko de Jonge, Robin Smithuis and Mario Maas From the Radiology Department of the Academical Medical Centre, Amsterdam and the Rijnland Hospital, Leiderdorp, the Netherlands. Location A stress fracture is an overuse injury. Bone is constantly attempting to remodel and repair itself, especially when extraordinary stress is applied. When enough stress is placed on the bone, it causes an imbalance between osteoclastic and osteblastic activity and a stress fracture may appear. Muscle fatigue can also play a role in the occurrence of stress fractures. For every mile a runner runs, more than 110 tons of force must be absorbed by the legs.

Bones are not made to withstand so much energy on their own and the muscles act as shock absorbers. As muscles become tired and stop absorbing, all forces are transferred to the bones. Stress fractures usually occur after a recent change in training regimen has taken place. Especially professional or recreational athletes and militairy recruits are subject to change in training intensity (increased), type of training or training circumstances (new shoes, other training surface etc.) and thus at increased risk of developing a stress fracture. However, sedentary people may also develop stress fractures if suddenly an active lifestyle is adopted. Insidious onset of pain and swelling over the affected region is the most important complaint, initially during the activity. With ongoing exposure, pain will last after the training, eventually causing the athlete to stop exercising.