bluuebunny/crossref_metadata_2025 huggingface dataset:
Polypharmacy, medicines optimization and concordance
Authors: Kaufman Gerri
Published: May 2014

This article explores polypharmacy and differentiates between appropriate and problematic polypharmacy. Issues associated with problematic polypharmacy, such as drug-to-drug interactions, adverse drug reactions, and underprescribing, are discussed. The concepts of compliance, concordance and adherence, which are terms commonly associated with patients following or not following treatment regimens, are explored. Medicine use review is explored as a holistic approach to optimizing medicines, promoting concordance, and achieving appropriate polypharmacy.
Pharmacology of steroids in the musculoskeletal system
Authors: Williams Anwen Siàn
Published: May 2014

Steroids, of both plant and animal origin, are a large group of fat-soluble organic compounds. The majority have important physiological actions. In the musculoskeletal system, they regulate bone growth and muscle development. The structural modification of naturally occurring steroids has generated thousands of derivatives; many of which are used in medicine. The synthetic analogs of glucocorticoids (e.g. prednisone, cortisone, hydrocortisone), often called corticosteroids, are used clinically across many diverse therapeutic domains (e.g. rheumatology, gastroenterology, oncology and dermatology). The terms glucocorticoid and corticosteroid are used interchangeably in the published literature. This article utilizes glucocorticoids (GCs) as a general descriptor encompassing both synthetic and naturally occurring analogues. It explains the rationale behind the use of GCs in the management of rheumatic diseases and provides a balanced view of the beneficial and detrimental effects of systemic GC treatment, using rheumatoid arthritis as the predominant disease example.
Clinical assessment and prescribing in minor illness
Authors: Silverston Paul
Published: May 2014

Clinical assessment is the process within a consultation that links the symptom that the patient presents with to the diagnosis and management plan that they leave with. The relationship between clinical assessment, diagnosis and prescribing is fundamental to safe practice. This article emphasises the importance of performing a symptom-based, patient safety-focused clinical assessment in clinical decision-making and patient management planning, so as to place patient safety at the heart of the consultation.
SuperSkin™: a polymer adhesive skin sealant
Authors: Williams Clare
Published: May 2014

SuperSkin™ can help to provide a barrier to mechanical and chemical trauma in skin that is at risk of breakdown.
Wandering and restraint: the carer's dilemma
Authors: Brennan Shirley
Published: May 2014

Shirley Brennan looks at the reasons behind wandering behaviour, the management methods used and the ethical dilemmas facing the professionals caring for the wandering client.
Skin allergy problems in patients with chronic leg ulcers
Authors: Cameron Janice
Published: May 2014

Janice Cameron discusses the possible allergic complications that may arise during treatment of leg ulcers, and the importance of avoiding the use of allergens during treatment.
Understanding stress: an overview
Authors: Gunn Lesley
Published: May 2014

Lesley Gunn looks at the effects, both positive and negative, that stress can have on our lives, and discusses some methods of dealing with stress in a constructive way.
The ideal home: a client's perspective
Authors: Ashurst Gretchen
Published: May 2014

Gretchen Ashurst gives a personal perspective detailing what she would expect from a residential home. Her experience as an auxillary nurse and her knowledge of the nursing home sector enables her opinion to be informed from both sides of the spectrum.
Positive customer care
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurstn examines the importance of projecting a positive image at work.
Community and residential homes pressure ulcer audit
Authors: Stevens Julie , Murphy Fiona , Smith Rowena
Published: May 2014

Julie Stevens, Fiona Murphy and Rowena Smith detail the aims, methods and findings of a trustwide baseline pressure ulcer audit of the patients registered on Hounslow and Spelthorne's district nursing caseloads.
Positive Customer Care
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst emphasises the importance of maintaining a good telephone answering policy to enhance the home's positive approach to customer care.
Psoriasis
Authors: Lawton Sandra
Published: May 2014

Psoriasis can affect between 1–3% of the general population. In this article, Sandra Lawton describes the diagnosis, management and treatment of this skin condition.
Health promotion among older people
Authors: Ramonaledi Sinna
Published: May 2014

Sinna Ramonaledi introduces health promotion and details how a client-centred approach needs to be adopted in conjunction with certain essential skills to allow successful health promotion among older people.
Laughter, there's no therapy like it
Authors: Freeman Ann
Published: May 2014

Ann Freeman tells the story of how an expedition to see a famous mouse brought a new sense of excitement and adventure to the residents and staff of a nursing home.
Social care
Authors: Lane David
Published: May 2014

David Lane analyses the current differentiation between nursing and residential homes and looks forward to a new way of working in the future.
SELF DIRECTED Learning
Authors: Yonwin Helen
Published: May 2014

This article by Helen Yonwin relates to unit CL1 of the NVQ syllabus: developing effective communication and relationships.
Making the best use of the recruitment process
Authors: Mangan Sonia
Published: May 2014

A job vacancy can be a good opportunity to remould the working structures in an organization, writes Sonia Mangan in this article on how to get the best out of the recruitment process.
Hutton: We will not follow Scots' free care
Authors: Hutton John
Published: May 2014

Nurses neglect ‘fundamentals of nursing’ says BBC

Some nurses appear to be unwilling to do things like feed patients, wiping bottoms or dealing with incontinent patients, according to a health watchdog, following a radio report claiming that there are increasing numbers of complaints against nursing staff.
Using evidence to inform decision making
Authors: Makinson Geoff
Published: May 2014

Developing originally as evidence-based medicine, evidence-based decision making has already grown to encompass all clinical practice and health care, and it is likely to be increasingly applied to health policy and health management issues.
Evaluating pain in care home residents with dementia
Authors: Closs SJ , Barr B , Briggs M , Cash K , Seers K
Published: May 2014

Care home residents with pain and dementia often have communication difficulties. This study tested the usability of a range of approaches to pain assessment for this group.
A guide to the Fixed-term Employees Regulations 2002
Authors: Richardson Barbara
Published: May 2014

Care workers often receive unequal treatment because of their fixed-term contracts. New regulations aim to provide job stability and equality. Barbara Richardson explains.
Book Reviews
Authors: Morgan Celly
Published: May 2014

This comprehensive package is designed to assist newly-appointed staff who work with people with learning disabilities to achieve a quality induction. However, it could just as easily be used to consolidate and recognize competence in more experienced staff.
Protecting individuals from abuse: a vital part of care
Authors: Pritchard Jacki
Published: May 2014

Jacki Pritchard explains why candidates need to understand that there are many different forms of abuse, and why they must develop skills in recognizing signs and symptoms as well as undertaking preventative work.
Choosing appropriate methods of wound debridement
Authors: Timmons John
Published: May 2014

When removing necrotic tissue to promote wound healing, it is essential that the techniques used and products applied are safe and effective. John Timmons explains.
Improving quality of life for clients with multiple sclerosis
Authors: Hartland Wendy
Published: May 2014

Multiple sclerosis cannot be cured, but its symptoms can be successfully managed. Wendy Hartland promotes a better understanding of this client group's specific needs.
Inductions to social care: the foundations of a sound career
Authors: Johnson Nick
Published: May 2014

The introduction of five standard units for the delivery of induction provides not only good guidance for employers but a way for new workers to have clear expectations.
The role of exercise in diabetes management
Authors: Kirk Alison , Mutrie Nanette , MacIntyre Paul , Fisher Miles
Published: May 2014

Physical activity has many benefits for all adults with type 2 diabetes. This article looks at how exercise recommendations can be applied to care home residents with the disease.
Considering issues of equality, diversity and rights
Authors: Humphries Jackie
Published: May 2014

Staff at all levels must be aware of the diversity of service users, and recognize the effect that their actions will have on others. Jackie Humphries advises on how to ensure equal treatment in the care home and maximize client empowerment.
The reasoning behind a good night's sleep
Authors: Wilson Sue
Published: May 2014

Sleep changes with age and lifestyle. In the first of two articles, Sue Wilson explains normal sleep patterns, and how a healthy sleep cycle can be maintained.
How to advise and support clients in the care home
Authors: Wright Michael
Published: May 2014

Michael Wright outlines ways of listening carefully, responding with respect, and using sensitive empathy to develop supportive relationships with clients, without getting overly involved emotionally.
Encouraging creativity through the arts and crafts
Authors: Wenborn Jennifer
Published: May 2014

The benefits of these imaginative activities are endless. Jennifer Wenborn demonstrates how to utilize creativity to best effect, and in turn help to promote lifelong learning.
Developing skills to perfect the art of communication
Authors: Nazarko Linda
Published: May 2014

At the heart of most complaints is poor communication, and if residents could improve one thing about those who care for them it would often be their communication skills. This article aims to enable you to communicate effectively.
Promoting success in mobility for residents with dementia
Authors: Oddy Rosemary
Published: May 2014

Dementia can adversely affect mobility. Rosemary Oddy suggests ways to avoid or minimize problems that care staff may encounter during their work.
An overview of bed and mattress use in care homes
Authors: Rush Anita
Published: May 2014

Beds and mattresses in the care home should enhance comfort and enable the client, and selecting is not an easy task. Anita Rush evaluates the types available.
Selecting and recruiting staff
Authors: Robbins Fiona
Published: May 2014

This optional unit in the RMA is about choosing the people you need to carry out your organization's work activities. Fiona Robbins explains.
Part one: The ancient healing art of reflexology
Authors: Anderson Linda
Published: May 2014

Linda Anderson introduces the series by giving an overview of this increasingly popular non-invasive pressure therapy, highlighting the benefits for older people.
Loneliness and the value of empathetic listening
Authors: Newson Pauline
Published: May 2014

Moving into a care home can symbolize for many the separation from family, friends and loved ones. Resident's exhibiting feelings of loneliness should be supported, reassured and encouraged to engage in their new environment.
Overseas nurses: Tackling discrimination
Authors: Larsen John Aggergaard
Published: May 2014

Overseas nurses working in private care homes and in the NHS face discrimination. New research highlights the importance of the manager taking a clear zero-tolerance approach to stop prejudice.
Detecting and preventing elder abuse
Authors: Ross Carrol
Published: May 2014

Elder abuse is a public health issue that can affect any older person at any time. Carrol Ross highlights the signs and symptoms that may help staff to identify abuse, and offers advice on responding to concerns and allegations.
Cardiology: palliative care
Authors: Nazarko Linda
Published: May 2014

People dying from heart failure should have the same access to palliative care as people who have cancer. Linda Nazarko discusses the role of the nurse in minimizing the symptoms of endstage cardiac failure and maximizing quality of life.
Selecting stoma care appliances and accessories
Authors: Williams Julia
Published: May 2014

In the second part of two stoma care articles, Julia Williams discusses the importance of selecting a secure, comfortably fitting and discreet appliance in the rehabilitation of the ostomate.
Care approaches to spirituality and dementia
Authors: Béphage Gaëtan
Published: May 2014

Understanding and addressing the spiritual needs of dementia patients can positively contribute to feelings of wellbeing. Gaëtan Béphage explores the concept and importance of spirituality in care.
Dual sensory loss: the effect of the care home environment
Authors: Swann Julie
Published: May 2014

Julie Swann continues the discussion of dual sensory loss. The importance of the care enviroment in facilitating daily living tasks and the general management of the condition are explored.
Pressure ulcer prevention within the care home
Authors: Stephen-Haynes Jackie
Published: May 2014

This article discusses how and why pressure ulcers form and considers the implications that the new EPUAP/NPUAP guidelines and the CQC will have across the care home sector.
Providing high quality dementia care in nursing homes
Authors: Nazarko Linda
Published: May 2014

Dementia is a complex condition and is difficult to manage well. Linda Nazarko discusses person-centered care and offers some solutions to the challenges presented by caring for residents with dementia.
Exploring recent developments in manual handling
Authors: Rinds Gitte
Published: May 2014

Practical solutions for reducing risk in manual handling are evolving rapidly. Gitte Rinds reports on some recent developments that may help improve the safety and wellbeing of residents and carers.
End-of-life care: making links with dementia care
Authors: Newson Pauline
Published: May 2014

Care that is given at the end of life is significant to each individual. It will also affect how the person's friends and family will remember their loved one. Pauline Newson describes the positive contribution that care assistants can make at this time.
NEWS ANALYSIS
Authors: Whittle Beccy
Published: May 2014

Beccy Whittle reports on plans for the future of a National Care Service.
Perception and the older person
Authors: Harrison Deborah
Published: May 2014

Deborah Harrison explores the practical and psychological theories on perception. Plus, some easy solutions to everyday challenges for staff working in residential care
Understanding and managing wound exudate
Authors: Hampton Sylvie
Published: May 2014

The fluid lost from chronic wounds can delay healing and cause damage if it is not properly dealt with. Sylvie Hampton explains how to manage this exudate to enable the wound to heal quickly.
Coping with common stoma problems in care homes
Authors: Black Pat
Published: May 2014

Some stoma problems can be dealt with in the home, some with specialist advice, but some signs require emergency attention. Pat Black tells us how all staff can look out for any signs of problems.
Practical skin care for people who are bed-bound
Authors: Hampton Sylvie
Published: May 2014

Residents unable to get out of bed need special attention for their skin. Sylvie Hampton gives front line staff practical advice for identifying, treating and preventing skin problems common in these people.
Safeguarding from deprivation of liberties
Authors: Campbell Annette
Published: May 2014

How aware are you of what a ‘deprivation of liberties’ actually is? Would you be able to identify it and know what to do about it? annette Campbell explains the legalities and what you can do to conform to these safeguards.
Wound infection assessment and management
Authors: Young Trudie
Published: May 2014

This article reviews the definitions surrounding wound infection, examines the assessment and management of infected wounds, and provides clinicians with the tools and guidance to enhance their clinical practice.
The taboo of senior sexuality: enhancing staff confidence
Authors: Heath Hazel , Riddett Jackie
Published: May 2014

Residents and staff can experience barriers in dealing with sexuality and intimate relationships. Hazel Heath and Jackie Riddett offer some frameworks for refection and suggestions on how problems can be overcome
Overseas nurses’ experience as support workers in the UK
Authors: Stuart Peter
Published: May 2014

Peter stuart explores the experiences of international nurses, working as support workers in the independent sector, of culture, racism, coping with reactions and understanding dementia
Hoisting a patient: principles and advice for safer practice
Authors: Wanless Stephen , Wanless Steve
Published: May 2014

Stephen Wanless and Steve Wanless provide guidance for the safe use of hoists and slings to instruct correct practice, reduce the incidence of injury to the health worker, and comply with laws and regulations
Preventing exposure to blood and body fuids
Authors: Beckett Gail , Bright Janice
Published: May 2014

Gail Beckett and Janice Bright summarise the correct procedures involved in the safe use and disposal of sharps and of cleaning up after potentially contaminated or infectious spillages of blood or body fuids
A good night's rest: identifying sleep disorders
Authors: Swann Julie I
Published: May 2014

In part one of a series discussing sleep disturbances, Julie swann explains some of the problems that residents may have going to bed and outlines the different classifcations of sleep problems
Improving oedema management through joined-up working
Authors: Todd Marie
Published: May 2014

Marie Todd outlines the focus of Scottish national guidelines and what care homes can learn from it to improve survival rates and residents’ physical and cognitive wellbeing and increase overall concordance by communicating efficiently with all health professionals
The Liverpool Care Pathway explained
Authors: Becker Robert
Published: May 2014

Care pathways are an important innovation in end-of-life care. Robert Becker offers guidance on how to understand this tool better and how to use it in practice in light of the recent media coverage and subsequent review
Understanding the functions required to maintain continence
Authors: Gardiner Angela
Published: May 2014

Angela Gardiner provides an outline of the signs and symptoms of faecal incontinence in addition to the assessment and management options employed in an attempt to enhance quality of life for people with the condition
Pressure ulcers: assessment and prevention in the early stages
Authors: Costa Bruno
Published: May 2014

Bruno Costa provides a guide for the assessment and prevention of pressure ulcers to improve wound-related health outcomes by implementing and integrating best practice
Shingles part one: following the guidance for vaccination
Authors: Nazarko Linda
Published: May 2014

The Government have introduced a routine vaccination for people aged between 70 and 79. In the first of this three-part series, Linda Nazarko highlights what the guidance entails and the benefits and risks of this for older people in care homes
Understanding pneumonia: anatomy and pathology
Authors: Driver Carolyn
Published: May 2014

In the first article of this three-part series, Carolyn Driver provides an explanation of how the lung infection, pneumonia, can be caused and how this affects the respiratory system in order to inform practice in care homes
New corporate offence of ill treatment: will you get caught?
Authors: Williams Poppy
Published: May 2014

Poppy Williams discusses the Department of Health's consultation on a recommendation for the creation of a new criminal offence of ill treatment and wilful neglect that will extend to the prosecution of organisations
Face-to-face Presenting to a prospect
Authors: Maiden Andrew
Published: May 2014

After months of planning, securing local support and refining application bids, a prospective donor expresses an interest in hearing more from you about the project. This may be your one chance. While you can spend hours refining minor details of any written proposal, once you are standing in front of your prospect, you must make the opportunity count.
Counselling for Norplant
Authors: Newton Patricia
Published: May 2014

Counselling for patients who decide to use Norplant is vital at every stage of consultation, says Patricia Newton.
Treatment of venous leg ulcers: Part 1
Authors: Williams Clare
Published: May 2014

In the first of a series of articles on wound care, Clare Williams describes the venous system and traces the history of venous disease.
Transactional analysis: Part 1
Authors: Bolden Keith
Published: May 2014

In the quest for better communication within the practice team, Keith Bolden's second article looks at the model of transactional analysis.
Schizophrenia and the practice nurse
Authors: McFadyen John , Ford Kelvin , Rigby Paul
Published: May 2014

John McFadyen and colleagues explain the new role for practice nurses in the care of the mentally ill.
Fever in the returning traveller
Authors: Felton Mark
Published: May 2014

A tourist returning home with a temperature may just have flu — or possibly something more exotic and life threatening. Mark Felton explains how to spot the difference.
School nurses come of age
Authors: Bailey Carol
Published: May 2014

Long gone is the image of ‘Nitty Norah’. Carol Bailey explains the recent innovations in this specialist branch of community nursing.
The changing face of district nursing
Authors: Barnes Eileen
Published: May 2014

District nurses are in a key pivotal position for many care professionals, says Eileen Barnes
Clinical supervision and practice nursing
Authors: Cook Rosemary
Published: May 2014

In the second article in her series, Rosemary Cook looks at the practicalities of clinical supervision.
Cryosurgery in the practice
Authors: Goodacre Selwyn , Wood Jean
Published: May 2014

Selwyn Goodacre and Jean Wood explain how to use this simple and effective technique to remove verrucas and warts.
Medicines: Drugs for asthma
Authors: Chapman Stephen
Published: May 2014

In the first in this series on medicines and their management, Stephen Chapman reviews drugs for asthma.
Opportunity or threat?
Authors: Chambers Ruth
Published: May 2014

Will the recent White Paper on primary health care offer GP practices a chance to innovate or is it a step backwards? Ruth Chambers investigates.
Medical abortion: The facts
Authors: Winfield Jane , Urwin Jane
Published: May 2014

Practice nurses have an important role supporting and advising patients contemplating medical abortion. Jane Winfield and Jane Urwin answer your questions.
A historical perspective
Authors: Flavelle Eileen
Published: May 2014

Over the last two centuries attitudes towards people with learning difficulties have changed dramatically. Eileen Flavelle looks back to the cruel inhumanity such people were dealt in the past.
Managing medicines: Antibiotics
Authors: Chapman Stephen
Published: May 2014

Stephen Chapman completes his series on the management of medicines with a survey on the use of antibiotics.
Building a healthier Britain
Authors: Lawrence Terry
Published: May 2014

Four years on, Terry Lawrence reviews the application and success of the government's Health of the Nation document.
Measuring change: The audit tool
Authors: Mathrani Shireen
Published: May 2014

Measuring behaviour change in health promotion is complex. Shireen Mathrani describes the audit tool launched last summer.
Banding in general practice
Authors: Bradley Annette
Published: May 2014

In 1992, the government recognised in its publication of The Health of the Nation (Department of Health, 1992) that there was a need for the development of a health strategy in primary care. Coronary heart disease (CHD) and stroke were proposed as the priority areas for general practice since it was thought this would be of greatest benefit to the patient in preventing illness and death from these conditions.
Putting risk in perspective
Authors: Greener Mark
Published: May 2014

People risk meeting their fate every time they cross a road, yet hints of drug side-effects in the press spread panic. Mark Greener investigates how people perceive personal risk and how nurses can help them.
Prostate disease in primary care
Authors: Pillinger John
Published: May 2014

With 45% of its population over 65, one Dorset practice provides an insight into health care in the 21st century. GP John Pillinger describes this practice's ground-breaking project to manage benign prostatic hyperplasia in primary care.
Quality: Industrial strength
Authors: Cook Laurie
Published: May 2014

Following the thalidomide scandal, quality assurance in the pharmaceutical industry is taken for granted, but things haven't always been this way. Laurie Cook traces how our stringent standards came about.
Prostate cancer: To screen or not?
Authors: Edwards Mandy
Published: May 2014

Many feel that screening for prostate cancer is of little benefit. But men should be given the choice to be screened so that they can make an informed decision, argues Mandy Edwards
Cervical screening: Improving quality
Authors: Patnick Julietta
Published: May 2014

Following recent mass cervical rescreening exercises, guidelines are being introduced to impose quality assurance — for the laboratory, colposcopy and the practitioner. Julietta Patnick stresses the importance of following them.
A racing start
Authors: Dunne Faith
Published: May 2014

As the Regency town of Cheltenham plays host to the 13th National Practice Nurse Conference, Faith Dunne talks to the organisers and finds that 13 is lucky for this year's delegates.
Confidentiality and mental health care
Authors: Rapaport Joan
Published: May 2014

Public safety is high on the political agenda. Joan Rapaport discusses the ethics of disclosing confidential health care information.
Onward, practice nurses…
Authors: Clough Ann-Marie
Published: May 2014

The 13th Practice Nurse Conference, recently held in Cheltenham, was a resounding sucess. Ann-Marie Clough reports on the events and some of the most important issues raised.
HIV and AIDS: Legal implications
Authors: Dimond Bridgit
Published: May 2014

Treating patients with AIDS or HIV is a legal minefield. Bridgit Dimond gives an update of where the practice nurse stands and where her duty lies.
Forces driving the agenda
Authors: Burgess Julie , Walker Carol
Published: May 2014

Julie Burgess and Carol Walker review the current situation in the field of coronary heart disease — the most common single cause of premature death.
Cardiac rehabilitation
Authors: McKay Janet
Published: May 2014

Jane McKay describes a cardiac rehabilitation programme from the patient's stay in hospital to building up long-term exercise patterns.
Salbutamol: in profile
Authors: Silverman Sue
Published: May 2014

Sue Silverman's new series profiles some of the most routinely prescribed drugs. The first looks at the beta-2 agonist, Salbutamol.
Mental health risk assessment
Authors: Chapman Sue
Published: May 2014

Sue Chapman describes a project to improve the treatments of mental health in primary care.
The practice nurse and HIV
Authors: Curtis Hillary
Published: May 2014

The minefield of prejudices that surround HIV makes the task of the practice nurse all the more difficult, as Hillary Curtis explains
Monitoring Drug Therapy in Arthritis
Authors: Glynn Ruth
Published: May 2014

Rheumatoid arthritis is treatable, but the current drugs need careful monitoring as Ruth Glynn explains.
Walk-in Clinic: Sore Throats
Authors: Fisher Pam , Glenn Kate
Published: May 2014

Sore throats are a painful but minor symptom of a wide variety of infections. Pam Fisher and Kate Glenn explain when the sore throat is a sign of a serious condition and when it is best left alone.
Children's Diabetes Specialist Nursing
Authors: Erez Joanne
Published: May 2014

The diabetes specialist nurse plays an important role in the education and support of children with diabetes, as Joanne Erez explains.
Primary Care and the CPA
Authors: Bailey Di
Published: May 2014

The Care Programme Approach has become the cornerstone of community care for the severely mentally ill. Di Bailey explains where primary care fits in.
Head Injury
Authors: Fisher Pam , Tyler Mark
Published: May 2014

Apparently minor injuries can have serious consequences, the most common cause of avoidable trauma death is failure to spot an intracranial haemorrhage. Pam Fisher explains.
Do PNs Want to Learn About Depression?
Authors: Armstrong Liz
Published: May 2014

The recently established National Depression Care Training Centre (NDCTC) commissioned a survey to establish the training needs of practice nurses nationwide.

A questionnaire was sent to 3000 nurses who had attended National Asthma and Respiratory Training Centre courses in the last 10 years. The response rate was 30% (1006) and revealed that the majority of respondents felt they did not have enough knowledge of diagnosing and treating depression. Even among those who had attended courses confidence in dealing with depression was very low.

In order to begin to tackle this situation, NDCTC has designed a 2-day pilot course which will be held initially at Nene College Northampton. This is an introductory course and developments will follow.
Which Dressing?: Part One
Authors: Pudner Rosie
Published: May 2014

Rosie Pudner helps you choose which dressing to use for which type of wound in this two part series.
Benign Breast Disorders
Authors: Clarke Eleanor
Published: May 2014

Breast cancer is common. Benign breast disease is commoner, and anxiety about breast disease commoner still.

Eleanor Clarke looks at these common disorders, that can cause undue anxiety.
Readers Respond
Authors: Plummer Sue , Martin Jeannett , Drake Linda , Daley Anna
Published: May 2014

PNs and depression

UKCC election results

Misleading advice

Making contact
What is cancer?
Authors: Richardson Pauline
Published: May 2014

Pauline Richardson explains the science behind the disease.
Migraine
Authors: Fisher Pam , Holmes Peter
Published: May 2014

Migraine is a common complaint which can have considerable impact on the patient's life. An effective treatment strategy is required, as Pam Fisher and Peter Holmes explain.
Readers Respond
Authors: Gupta Karen , Sibson Lynda
Published: May 2014

Being downgraded?

Telemedicine correction
PNs: Facilitators of Learning?
Authors: Carter Rachel
Published: May 2014

This study considered the feasibility of practice nurses supervising Diploma of Higher Education (Nursing) students for a short practice placement. Ten practice nurses facilitated a 10 day placement at the commencement of the Branch Programme. The results of this placement were compared to that of a control group of ten students who were facilitated by health visitors, the usual practice placement at this time.

Information was gathered from both facilitators and students prior to and upon completion of the placement through interview and questionnaire. It was found that students facilitated by practice nurses consistently move further forward in their learning outcomes and competency than students facilitated by health visitors. The study demonstrated that practice nurses are a valuable resource for educating students which has to date not been appropriately utilised
Obesity: A Weighty Problem
Authors: Hunter Colin
Published: May 2014

As we creep towards the millenium, the problem of obesity is growing not reducing. Colin Hunter describes a Scottish initiative which aims to stop this trend and promote healthy weight maintenance.
Setting the Records Straight: 2
Authors: Dimond Bridgit
Published: May 2014

Some practices are venturing towards patient-held records. Bridgit Dimond explores when a patient can and cannot have access to their records and the reaches of the practice nurse's duty of confidentiality.
Is There Any Need for a Bleed?
Authors: Abernethy Kathy
Published: May 2014

Thanks to extensive media coverage and increased emphasis on health promotion within primary care, the subjects of menopause and hormone replacement therapy (HRT) have been brought to the attention of many women.
Walk-in Clinic: Dysmenorrhoea
Authors: Johnson Wendy , Johnson Stephen
Published: May 2014

Dysmenorrhoea, or painful menstruation, comes from the Greek meaning difficult monthly flow. It is one of the commonest gynaecological complaints, experienced to some degree by 60–75% of women (Llewellyn-Jones, 1990), and more than half of adolescent girls report analgesic use (Nafstad et al, 1993).
Consent to Treatment
Authors: Rodgers ME
Published: May 2014

A patient must give consent before being examined, injected or operated upon. ME Rodgers explains the legal aspects of consent to treatment.
Protocol Development: Attitudes Among GPs and Practice Nurses
Authors: Cotton Philip , Ross Sue , Sullivan Frank
Published: May 2014

The Scottish Intercollegiate Guideline Network (SIGN) is producing a series of national guidelines, the first two of which are now available, for local implementation. The translation of guidelines into local protocols will involve many disciplines particularly practitioners. The rapid growth of the guideline industry has generated many concerns and misunderstandings which need to be addressed. A survey of all doctors and nurses working in primary care has revealed differences in perception of guidelines arising partly from different roles and responsibilities. However differences also emerge in terms of access to information used in the development of practice based guidelines. Multidisciplinary collaboration over guideline development and implementation requires equitable access to and understanding of the processes involved and of the information needed. This has implications for methods of collaboration and consultation and the training of practitioners for these tasks.
Untrained, Unregistered and Unaccountable
Authors: Richards Sue
Published: May 2014

Untrained health care assistants are taking over roles that used to be reserved for nurses. Sue Richards wants a debate on their registration.
Mens health: slugs and snails?
Authors: Chell Steve , Jones Dennis , Hughes Nigel , Saunders Ralph
Published: May 2014

A like-minded group of health professionals got together in Bradford and Airedale in 1997 to form the Health of Men (HOM) group. Initially, the idea was to provide a forum for debate and share good practice in the area of male health promotion. The activities of the group have since expanded to try to redress the inequalities that exist in men's health by providing a direct men's health service.
Preventing osteoporosis: the practice nurse's role
Authors: Bates Victoria
Published: May 2014

Victoria Bates reviews the prevalence of osteoporosis in the UK and suggests ways in which nurses and patients can work together to help manage menopausal symptoms more effectively
Male eating disorders
Authors: Peate Ian
Published: May 2014

Ian Peate considers the implications of the case of Colin, a gay man with a history of anorexia and bulimia since the age of 12. He argues that eating disorders are often overlooked in men and the illness may become well established and cause longterm suffering before treatment is offered.
Contraception on the internet
Authors: Berrisford Simon
Published: May 2014

The highly personal matter of contraception can sometimes pose quite a challenge to practice nurses, who are often the first port of call for patients wanting to explore all the choices available to them. Therefore, practice nurses need to be well-informed about all aspects of contraception to provide patients with appropriate and enlightening answers to their questions and a clear understanding of the issues.
Can teenage pregnancy be halved?
Authors: Styles Julia Ann
Published: May 2014

General practice may need additional resources if new strategies are to halve the rate of teenage pregnancy, according to the government's aim. Julia Styles explains why health professionals need appropriate training and a sensitive approach to provide effective contraceptive advice.
Picture Quiz 14
Authors: Watts Jane , Peters Jill
Published: May 2014

John, a 42-year-old computer operator, presented to the clinic with an itchy plaque on his left ankle. It had been present for around 2 years and had caused him no pain but some discomfort as a result of persistent itching. His wife had urged him to seek help, because she had become aware of John's constant scratching and rubbing of the lesion. John had no history of any skin problems and there was no family history of eczema or psoriasis. On examination, there was a well-defined, lichenified (thickened) plaque, covered with a white scale, close to the left ankle.
New antihistamine for hay fever and allergy
Authors: Wood Stuart
Published: May 2014

Stuart Wood evaluates what is known so far about the potential of NeoClarityn, a new antihistamine treatment for hay fever and other allergic symptoms.
Building practice nurse research capacity
Authors: Davies Jacqueline , Heyman Bob , Bryar Rosamund , Graffy Jonathan , Gunnell Caroline , Lamb Bryony , Morris Lana
Published: May 2014

Jacqueline Davies and colleagues report the results of their study of the research interests of practice nurses in East London and Essex
Reducing the risks of coronary heart disease
Authors: Hurley Gemma
Published: May 2014

Coronary heart disease (CHD) remains the leading cause of mortality and morbidity in the UK (Lindsay et al, 1995). The Department of Health (2000) reports that 300000 people have heart attacks in Britain each year and more than 110000 people die from heart-related problems in England. Scotland and Northern Ireland continue to lead the world with the highest rates of CHD (British Heart Foundation Health Promotion Research Group, 2002).
Diabetes
Authors: Beckwith Sue
Published: May 2014

Diabetes mellitus can affect the skin in many ways. Most commonly foot lesions occur which are the result of neuropathic and atherosclerotic abnormalities. Bacterial and fungal infections are more common in diabetics than in the rest of the population.
Selecting an inhaler
Authors: Pearce Linda
Published: May 2014

Inhaled therapy is the mainstay of pharmacological management for a number of respiratory diseases and is an effective drug delivery route (Global Initiative for Asthma, 2002). In the future, inhaled delivery may be used for systemically acting drugs such as insulin and analgesics.
Dermatology Clinic
Authors: Watkins Jean
Published: May 2014

Chronic candida paronychia tends to occur in people, often women, who frequently immerse their hands in water, e.g. housewives, nurses, barmaids, chefs or hairdressers. People with diabetes mellitus or vaginal candidosis are also more susceptible.
Teaching technique:Part 1
Authors: Pearce Linda
Published: May 2014

Inappropriate device selection and incorrect inhaler technique are the most common reasons for treatment failure alongside lack of concordance (Pearce, 2002). Therefore inhaler device selection should be a key component of any consultation. A wide range of devices is available, and new devices are regularly added to the range. Inhalers may be classified as either pressurized metered dose inhalers (pMDIs) or dry powder inhalers. This article discusses the technique for pMDIs.
Involving the patient in leg ulcer management
Authors: Bentley Jenny
Published: May 2014

In the final article in this series, Jenny Bentley considers the importance of involving patients in treatment decisions
Practice protocols for pneumococcal disease
Authors: Willcox Adrienne
Published: May 2014

The Chief Medical Officer has announced that pneumococcal vaccination will be offered to everyone over 80 years of age from 20 August 2003. Adrienne Willcox explains how to set up a practice protocol for an immunization programme
Improving access to care for the learning disabled
Authors: Black Dorothy
Published: May 2014

Dorothy Black describes a small study whose aim was to raise awareness among primary health professionals of the difficulties faced by people with learning disabilities in accessing primary health care
Building practice nurses’ research capacity
Authors: Abbott Stephen , Gunnell Caroline
Published: May 2014

Stephen Abbott and Caroline Gunnell coordinated a study of diabetes patients’ experiences of health services with the aim of encouraging greater participation in research by practice nurses
A new distance-learning course in skin care
Authors: Penzer Rebecca
Published: May 2014

Rebecca Penzer introduces a new distance-learning course to help practice nurses improve care for people with chronic skin conditions.
Scarlet fever and fifth disease
Authors: Watkins Jean
Published: May 2014

Patients with scarlet fever and fifth s disease (erythema infectiosum) present relatively frequently in the surgery to the nurse. In both cases the patient will have signs of a flushed face and cheeks. However, the cause and accompanying symptoms of the two conditions vary. Further history taking and examination of the patient is required to be confident about the diagnosis, so that the right advice and treatment can be recommended.
Management of migraine by nurses
Authors: MacBean Heather , Leech Julie , Dungay Jan , Dowson Andrew J
Published: May 2014

Heather MacBean, Julie Leech, Jan Dungay and Andrew Dowson explore the role of practice nurses in the management of migraines
Discussing diabetes
Authors: Holt Richard
Published: May 2014

The Diabetes UK Annual Professional Conference will be held in Glasgow from 20 to 22 April. This meeting attracts over 3000 delegates from diverse health professions involved in the care of patients with diabetes as well as industrial partners. It provides plenty of opportunity to meet with colleagues and share information and ideas about the latest developments in the science and clinical care of diabetes. It also hosts an exhibition of over 50 exhibitors, including pharmaceutical companies and voluntary organizations. Almost 400 abstract posters will be on display and there will be a banquet on Thursday night. All this will ensure an event with something for everyone.
Up-Coming Drugs
Authors: Ali Omar
Published: May 2014

Nicotine replacement therapy (NRT) is not new to health professionals or patients. It has been used successfully to help people stop smoking for a number of years. But never before has an NRT product been licensed to help stop smoking by ‘cutting down, then stopping’.
The use of automated external defibrillators
Authors: Lambert Jane
Published: May 2014

Jane Lambert explains the key things you need to know about resuscitating a patient using an automated external defibrillator
Taking the first steps on your learning journey
Authors: Rivers Sue
Published: May 2014

Learning is an individual experience. Sue Rivers guides us through the steps of the learning journey and describes the different approaches we can take and how to get the most out of the experience
Unhappy children
Authors: St John Tara
Published: May 2014

The UK's poor showing in the UNICEF report on children's wellbeing (2007) comes as no surprise to many of those working in health and social care. The problems are not new and an increasing number of young people are developing mental health problems.
Controlling TB
Authors: Proudfoot Celia A
Published: May 2014

The incidence of tuberculosis is rising. Celia Proudfoot reviews the current recommendations for diagnosis, management, vaccination and control
Giving a life back with flexible care
Authors: Hall Sue
Published: May 2014

Sue Hall explains how flexible care can help isolated older people re-establish social contacts to improve quality of life. She looks in particular at the award-winning work of the Oxfordshire Flexible Care Service
Hypoglycaemic attacks
Authors: Beckwith Sue
Published: May 2014

Master J, an adolescent with type 1 diabetes, arrived at the surgery for blood to be taken for haemoglobin A1c (HbA1c) estimation. During this procedure he appeared vague and preoccupied and was pale and sweating profusely. This was not his normal reaction to venepuncture. When asked if he was feeling alright he appeared confused. His blood glucose was found to be 3.1 mmol/litre which confirmed a diagnosis of hypoglycaemia.
Paris meeting promotes HPV vaccine
Authors: Cooper Maggie
Published: May 2014

Maggie Cooper reports on proceedings at the First Global Summit on Cervical Cancer, held in Paris on 22 March
Clinical Q&A
Authors: Carrier Judith , Brassey Jon
Published: May 2014

The NLH Question-Answering Service was Martin Davies' month set up for primary care practitioners to ask any question related to their clinical practice. Below are two questions asked recently. For full answers and references please refer to the NLH website at www.clinicalanswers.nhs.uk
Managing epilepsy in young women
Authors: Linklater Anthony
Published: May 2014

National Epilepsy Week runs from 20–26 May. Anthony Linklater considers the incentives to improve epilepsy management in the QOF and looks at the key issues to address in young women with epilepsy
Alcohol consumption: Risks and benefits
Authors: Foster Rebecca
Published: May 2014

Concerns about binge drinking have provoked a variety of measures including legislative changes and educational campaigns but there is evidence that moderate alcohol intake may have health benefits. Rebecca Foster investigates
A wealth of knowledge for patient care
Authors: McGeoghegan Carolyn
Published: May 2014

The education-packed day at this year's Scottish Practice Nurse Association conference was a successful remedy for further knowledge. Carolyn McGeoghegan reports.
Access to travel health resources in Wales
Authors: Joyce Nicola , Cottrell Simon , Roberts Richard
Published: May 2014

There is limited information about decision-making by nurses during travel health consultations in general practice, and on practice nurses' access to travel health training. A postal questionnaire was sent to the senior practice nurse in all 528 general practices in Wales to investigate nurses' travel health training and use of information resources.

Results. The response rate was 48%. Almost half of respondents had accessed a training course within the last year and a majority used respected paper or online sources of travel health information. Recent training had a positive effect on the use of online resources.

Conclusions. Practice nurses' access to travel health training in Wales often depends on the size of the practice. It is important for practice nurses to consider their travel health training and information needs. Nurses need support from practices and primary care organizations to ensure that they can access to up-to-date information and training.
Flu: Younger risk groups
Authors: Noakes Karen , Salisbury David
Published: May 2014

Karen Noakes and David Salisbury explain why a key aim for this year's flu vaccination campaign is to improve uptake among younger at-risk groups
A changed world
Authors: Benison Líam
Published: May 2014

The world has changed since I wrote my last editorial 2 months ago. Banks once considered impregnable have been nationalized, the economies of European nations have been given IMF support, and old certainties about the benefi ts of leaving things to market forces have been overturned in weeks by the same political leaders who espoused them for decades. It remains unclear how these events will affect the NHS, where market-based instruments such as the QOF and payment by results have been introduced to raise standards.
Using emergency oxygen in general practice
Authors: Peffers Sarah-Jane , Scullion Jane
Published: May 2014

Sarah-Jane Peffers and Jane Scullion explain the new recommendations of the British Thoracic Society on the use of emergency oxygen therapy
Diagnosis and risk assessment
Authors: MacArthur Clare
Published: May 2014

In the first article in a monthly series reviewing the management of diabetes in general practice, Clare MacArthur explains the key steps in a diagnosis of diabetes and why early diagnosis is so import