bluuebunny/crossref_metadata_2025 huggingface dataset:
The risks of misconception
Authors: Siddall Rhonda
Published: May 2014

Rhonda Siddall explains the benefits of the Angina Plan, which aims to improve patients' quality of life by addressing misunderstanding of this burdensome condition.
Caring for older people with dementia
Authors: Brown Margaret M
Published: May 2014

Margaret M Brown investigates how practice nurses can contribute to the early diagnosis of people with dementia in light of the National Service Framework for Older People. She shows that opportunities exist to work in conjunction with other health and social services for the ongoing care of these people.
The persistence of ADHD into adulthood
Authors: Young Susan
Published: May 2014

It is often unrecognized that attention deficit hyperactivity disorder (ADHD) persists into adulthood and can affect adults as severely as children. Dr Susan Young explains.
Concordance with long-term oxygen therapy
Authors: Baird Anne
Published: May 2014

Anne Baird discussed the treatment of COPD with inhaled steroids in her previous article in the July issue. Here she considers the benefits of long-term oxygen therapy and considers the benefits for Mrs White.
The consequences of male unemployment
Authors: Peate Ian , Greeno Mary
Published: May 2014

Ian Peate and Mary Greeno investigate some of the ways that unemployment impacts on men's health and wellbeing and argue that practice nurses can contribute to improving the health of men in general.
Clinic Asthma
Authors: Booker Rachel
Published: May 2014

Mary is a 59-year-old woman who presents with a winter chest infection. Do her symptoms indicate asthma, COPD or something else? Rachel Booker investigates.
Clinic Diabetes
Authors: Wiltshire Sula , Beckwith Sue
Published: May 2014

When a district nurse calls on a patient after his myocardial infarction, she discovers a woman who has recovered from diabetes. Sula Wiltshire and Sue Beckwith trace the origins of Mrs B's belief.
Patient power and litigiousness
Authors: Tingle John
Published: May 2014

John Tingle considers nurses' need for greater awareness of health law as government policy encourages the growth of patients' power.
Security and the Internet
Authors: Berrisford Simon
Published: May 2014

It is hard to imagine in this day and age how we could possibly do without the Internet. Apart from instant access to a wide range of reference resources, we now use it for shopping, keeping up to date with the latest news and even for meeting our lifelong partners. However, it is worthwhile being aware of, and prepared for, potential security risks that can, albeit rarely, cause problems within the Internet.
Hepatitis A
Authors: Howell Karen
Published: May 2014

Immunization is essential for travellers to countries with high rates of hepatitis A. Karen Howell also reveals that many people in the UK are infected by the virus at home
Clinic Diabetes
Authors: Beckwith Sue , Wiltshire Sula
Published: May 2014

Sue Beckwith and Sula Wiltshire consider the case of 18-year-old Sam, a diabetic whose hypoglycaemia is discovered when she presents at morning surgery for thrush.
Clinic Asthma
Authors: Weller Trisha
Published: May 2014

Nine-year-old Kim's asthma is poorly controlled.Trisha Weller explains how reviewing her medication and discussing symptom management with Kim and her mother can help improve Kim's enjoyment of life
Diabetes
Authors: Beckwith Sue , Wiltshire Sula
Published: May 2014

Elaine becomes distressed when she is diagnosed with type 2 diabetes soon after giving birth to her second baby. How can her practice nurse encourage her to adapt her lifestyle and manage the condition?
Alzheimer's disease: The diagnosis dilemma
Authors: O'Broin Kate
Published: May 2014

Early diagnosis of Alzheimer's disease is the key to providing appropriate treatment, argues Kate O'Broin. Like many people with Alzheimer's, Jane expresses her experience eloquently and can contribute to decisions about her treatment.
Charities on the internet
Authors: Berrisford Simon
Published: May 2014

Has it ever crossed your mind how helpful it would be to have access to a list of charities that could help your patients? It probably has, but does one exist? And how do you find it?
Recognizing nurses' training needs
Authors: Merricks Barbara , Halliwell Karen
Published: May 2014

Karen Halliwell and Barbara Merricks outline the objectives of Bournemouth University's new course tailored to the special professional needs of practice nurses.
Atopic asthma and allergen avoidance
Authors: Siddall Rhonda
Published: May 2014

Clinical history and skin prick testing contribute to the diagnosis of allergic asthma, explains Rhonda Siddall, who assesses the value of allergen avoidance in treating a disease in which the precise role of allergy is still poorly understood.
Statins, cholesterol and coronary risk
Authors: Maynard Janet
Published: May 2014

In the first of a series of articles on topical prescribing issues, Janet Maynard discusses the issues to be considered when prescribing drugs for cholesterol and the prevention of coronary heart disease.
Helping smokers quit in primary care
Authors: Ali Julie
Published: May 2014

Julie Ali reports on the progress of primary care smoking cessation services in south London where Zyban has been introduced to help people give up the habit.
Clinic Emotional Health
Authors: Watkins Jean , Armstrong Elizabeth
Published: May 2014

In the first of a new series focusing on the presentation of emotional symptoms in general practice, Jean Watkins and Elizabeth Armstrong question whether the pill is making Mary depressed.
Ethics and inequalities in healthcare
Authors: Benison Líam
Published: May 2014

The annual practice nurses' conference will be held this year at Felsted School in Essex from 4–6 July. The editor considers some key issues to look out for.
Treatment consensus from Edinburgh
Authors: Pinn Stephen
Published: May 2014

A recent conference on COPD in Edinburgh issued a consensus statement on the optimal treatment of COPD. Stephen Pinn reports on the use of lung function tests, health status checks and some additional innovations in COPD management.
Embarrassing but potentially curable
Authors: Bardsley Alison
Published: May 2014

Incontinence can often be cured and, in many cases, can be better managed, but many people fail to seek help. Alison Bardsley reviews the diagnosis and treatment of this highly embarrassing and distressing condition.
A new hydrophilic foam dressing
Authors: Hampton Sylvie
Published: May 2014

Selection of appropriate wound dressings can be confusing because of the plethora of dressing types that are available. Dressings do not contain magical properties, and it is only, therefore, careful and knowledgeable selection of appropriate dressings that will lead to successful healing of a wound and benefit for the patient.
Nurse power and regulatory change
Authors: Castledine George
Published: May 2014

George Castledine looks at changes to the regulatory authority for nursing and considers why nurses' power to shape policy is waning.
A nurse-led emergency contraception service
Authors: Alexander Pauline , Baskerville Carol
Published: May 2014

Pauline Alexander and Carol Baskerville report on the estabishment of an out-of-hours emergency contraception clinic in Chester.They discusses the requirements of an effective contraceptive service that responds to the needs of people.
Talking about cancer and sexual health
Authors: Williams Tracy
Published: May 2014

Tracy Williams examines the ways that cancer can impinge on patients' sex lives, and argues that nurses have an important role to play in discussing these problems with patients and providing help.
How to take a sexual health history
Authors: Peate Ian
Published: May 2014

Ian Peate outlines the questions that should be considered when taking a patient's sexual health history. A non-judgmental open-minded approach is most effective at encouraging patients to reveal information voluntarily.
Clinic Emotional Health
Authors: Watkins Jean , Armstrong Elizabeth
Published: May 2014

Gemma is concerned about an irritating vaginal discharge that seems to defy medical explanation. Dr Jean Watkins and Elizabeth Armstrong consider how to help her.
Clinic Diabetes
Authors: Wiltshire Sula , Beckwith Sue
Published: May 2014

Tom is a 52-year-old man who is unemployed and homeless. His social circumstances pose several difficulties for treating his suspected diabetes, as Sula Wiltshire and Sue Beckwith explain.
Well aware on the internet
Authors: Berrisford Simon
Published: May 2014

A refreshing and easy-toaccess website is up and running with the sole purpose of making you, the user, well aware and more informed about a variety of general health problems that your patients may present with. The creators of www.Well-Aware.co.uk are all too aware of the limited time that patients have available to them during the average consultation to discuss their condition and treatment options with their practice nurse or doctor. This was one of the primary considerations of the website's founder, Dr Catherine Minto, Specialist Registrar and Research Fellow at University College Hospital in London.
Antihypertensive drugs and monitoring
Authors: Maynard Janet
Published: May 2014

In the second of a series of articles on topical prescribing issues, Janet Maynard outlines the use of antihypertensive drugs and recommends regular monitoring of all patients with hypertension.
Tuberculosis
Authors: Howell Karen , Marlowe Sharon
Published: May 2014

Tuberculosis is a major and growing public health problem throughout the world. Karen Howell and Sharon Marlowe explain its clinical features, methods of control and treatment, and the risks for travellers.
Strategies to improve concordance
Authors: Burgess Vanessa
Published: May 2014

Vanessa Burgess explores some communications techniques which can improve patients' concordance with medication regimens.
How to take scabies scrapings
Authors: Casey David , Roberts Carol
Published: May 2014

Human scabies is caused by the mite Sarcoptes scabiei, which burrows into the outermost layer of the skin, the stratum corneum. In classical scabies an individual may carry 10–20 adult mites on the body. Progression to Norwegian scabies occurs in immunosuppressed people, resulting in many more mites being found on the host.
Dual therapy for asthma comes of age
Authors: Holmes Bill
Published: May 2014

Dr Bill Holmes considers the advantages of a combined therapy for asthma, salmeterol and fluticasone propionate, over increasing the dose of corticosteroid.
A day at Woking walk-in centre
Authors: Allcock Alison
Published: May 2014

For Alison Allcock, wall-punching patients, ear syringing, tonsillitis, ECGs and gluing lacerations to the head are all in a day's work.
Results from an audit of mental health services
Authors: Scurfield Peter
Published: May 2014

Peter Scurfield reviews the needs of older people with mental health problems and looks at the support given to primary care professionals
Blepharitis, styes and cysts
Authors: Cook Elizabeth
Published: May 2014

There are many different eye conditions. One of the most common is conjunctivitis, which occurs in both allergic and bacterial or viral forms, and was discussed in the last issue. Blepharitis, meibomiam cysts, entropion and styes are other eye conditions that may be seen by practice nurses responsible for minor illnesses.
Disabilities
Authors: Townend Mike
Published: May 2014

Mike Townend discusses the needs of travellers with mobility, sight and hearing disabilities, and advocates good preparation before departure
CLINIC Cardiology
Authors: Daniels Luci
Published: May 2014

Diet and life-style advice are essential for John following coronary bypass surgery. Luci Daniels explains how to advise him to reduce his risks of coronary heart disease.
Expressing values in health policy
Authors: Gough Pippa
Published: May 2014

Pippa Gough told Liam Benison about the formative experiences of her nursing career and her ideas on nursing professionalism
Dermatology Clinic
Authors: Watkins Jean
Published: May 2014

Eczema and tinea on the hands are often difficult to distinguish but require quite different treatments. Dr Jean Watkins discusses their presentation and poses three questions to test your understanding.
Cost-effectiveness in wound dressing selection
Authors: Gray DG , White RJ , Russell F , Cooper PJ
Published: May 2014

DG Gray, RJ White, F Russell and PJ Cooper conducted a cohort study of the clinical and cost-effectiveness of primary and secondary dressings for non-infected superficial wounds
New antihypertensive for diabetic renal disease
Authors: Daly Heather
Published: May 2014

Heather Daly reviews irbesartan, a new angiotensin II receptor antagonist for diabetic renal disease
Japanese encephalitis
Authors: Driver Carolyn
Published: May 2014

Carolyn Driver looks at risk assessment for Japanese encephalitis and investigates which travellers may need vaccination
How to keep your hands clean
Authors: Griffiths Elizabeth
Published: May 2014

Hand washing is an effective means of controlling infection (Gould et al, 2000) but health professionals do not always practice effective technique (Larson and Killien, 1982).
Clinic Diabetes
Authors: Beckwith Sue
Published: May 2014

Jack Broadhurst has won a chance to take his wife and daughter to Disney World and he is worried about flying for the first time. Sue Beckwith considers how his diabetes should inform his travel preparations.
Guiding smokers on the road to quitting
Authors: Percival Jennifer
Published: May 2014

On the eve of No Smoking Day, Jennifer Percival discusses the challenges of helping people quit smoking and provides a comprehensive guide to resources for practice nurses.
Adjust insulin to your diet: Dream or reality?
Authors: Reid Helen
Published: May 2014

Helen Reid explains the philosophy behind DAFNE, an education course that frees people with type 1 diabetes to eat what they like when they choose.
Dermatology Clinic
Authors: Watkins Jean
Published: May 2014

It is often difficult to diagnose moles and decide whether a patient needs urgent referral or general advice. Dr Jean Watkins discusses two varieties of mole and poses two questions to test your understanding.
Insulin delivery:The end is in the beginning
Authors: Bushby Phyllis
Published: May 2014

How newly diagnosed patients first learn to inject insulin is crucial to the long-term successful control of diabetes. Phyllis Bushby reviews some of the concerns and suggests some practical solutions when starting a patient on insulin.
Patients' PALS set to change primary care
Authors: Alexander Malcolm
Published: May 2014

Six new bodies will deal with patient complaints and advocacy from April. Malcolm Alexander explains their roles and considers their potential.
Continuing change
Authors: Saunders Diana
Published: May 2014

The new financial year starts in April and will usher in more change in the NHS. Arguably, the most radical change this April is the introduction of strategic heath authorities (StHA) across England and the demise of the old health authorities and regional offices. Just to add to the upheaval, several new primary care trusts (PCTs) will start to work at level 4, and a new GP contract will be released for consultation.
Expert patients are more enjoyable
Authors: Cooper Jane , Jones Roy , Thompson Jean
Published: May 2014

Jane Cooper, Roy Jones and Jean Thompson explain how self-management training for patients with long-term illnesses can make clinicians' work easier.
Respiratory illness
Authors: Townend Mike
Published: May 2014

Mike Townend investigates the effects of flying on people with asthma and COPD. These people should be advised to plan ahead for travel and to carry medication with them on the aircraft
Cleaning and use
Authors: Jennings Jacqui
Published: May 2014

The term ‘nebulizer’ is commonly used to refer to an assembly of parts which includes a chamber (the nebulizer proper), a compressor, tubing, and either a mask or mouthpiece. In this article, ‘nebulizer’ in the singular refers to the chamber only.
Clinic Women's Health
Authors: Smith Elizabeth
Published: May 2014

Tracy has an unwanted pregnancy and decides on a termination. Elizabeth Smith follows Tracy through her termination and considers the nurse's role in early medical abortion.
Clinic Diabetes
Authors: Beckwith Sue
Published: May 2014

Jody has been taking insulin for 15 years and is asked to take daily urine samples for microalbuminuria screening. Sue Beckwith explains how to advise her about renal disease.
New formulation helps nurses treat acromegaly
Authors: Roberts Betty
Published: May 2014

Acromegaly is a rare condition in adults with potentially fatal complications if left untreated. Betty Roberts explains why a new formulation of lanreotide enables more practice nurses to administer monthly injections and provide valuable support for patients
A practice nurse led by her nose
Authors: Hall Gwen
Published: May 2014

Gwen Hall's nosiness drove her to specialize in diabetes and nurse education. She kindly agreed to speak to Líam Benison about her career.
Clinic Cardiac
Authors: Lane Gary
Published: May 2014

Harry is a 72-year-old, life-long smoker and heart attack survivor who has become increasingly breathless. Gary Lane investigate his diagnosis and management.
Clinic Respiratory
Authors: Stearn Ruth
Published: May 2014

How does asthma affect pregnancy? Helen is an asthmatic in her mid thirties. She has two children and has had two miscarriages. She is now pregnant for the fifth time. Ruth Stearn investigates.
Changing practice with PCT support
Authors: Bailey Doriann
Published: May 2014

Doriann Bailey spoke to Líam Benison about how practice nurses at Manchester Central PCT are improving patient care in local practices
CLINIC Diabetes
Authors: Beckwith Sue
Published: May 2014

Diabetic retinopathy is the most common cause of blindness among people of working age. Sue Beckwith considers what advice to give Mrs Beveridge when she visits for her annual diabetic review.
The diabetic traveller
Authors: Townend Mike
Published: May 2014

Mike Townend reviews the preparations that people with diabetes should make before travelling, and the advice they should be given at a pre-travel assessment.
NICE guidance on smoking cessation
Authors: Roberts June
Published: May 2014

Smoking cessation is cost effective, argues June Roberts in her review of smoking cessation guidelines from the National Institute for Clinical Excellence (NICE)
Overcoming erectile dysfunction
Authors: Russell Ian
Published: May 2014

Ian Russell reviews apomorphine SL, an oral treatment for erectile dysfunction
Improving dermatology in primary care
Authors: Penzer Rebecca
Published: May 2014

Rebecca Penzer considers how dermatology services can be improved in primary care and the value of further education in dermatology for practice nurses
Conjunctivitis
Authors: Cook Elizabeth
Published: May 2014

The skin covering the white part of the eyes is called conjunctiva. It turns back under the eyelids and forms the skin on the inside of the eyelids. Conjunctivitis, therefore, means an inflammation of the conjunctiva. There are two main causes of conjunctivitis: infections and allergies.
Diphtheria, tetanus, polio
Authors: Driver Carolyn
Published: May 2014

Carolyn Driver explains in which circumstances travellers require vaccination against diphtheria, tetanus or poliomyelitis.
CLINIC Cardiology
Authors: Baines J , Gisborne L
Published: May 2014

A nurse-led service in an inner-city PCT demonstrates how specialist nurse intervention can alleviate the overall burden of chronic heart failure by limiting costly hospital admissions and improving quality of life
Letter
Authors: Craddock Jo
Published: May 2014

Jo Craddock seeks input from readers for her dissertation on professionalism.
Menstruation
Authors: Sinclair Jean
Published: May 2014

Jean Sinclair investigates the options for young women travellers who expect to have their periods while away
CLINIC Cardiology
Authors: Carr Nancye
Published: May 2014

Oral anticoagulation therapy presents several challenges. In the first of a three-part series on the sources of error in management, Nancye Carr looks at the background and the potential for prescribing errors
Immunomodulators' role in atopic eczema
Authors: Allerdyce Claudette
Published: May 2014

Claudette Allerdyce discusses a new class of drug therapy known as topical macrolide immunomodulators for the treatment of atopic eczema.
Becoming a practice partner
Authors: Gibb Karen
Published: May 2014

Karen Gibb is a practice nurse who has become a partner in her practice. She explains how and why she took this step
Arboviral infections
Authors: Chiodini Jane
Published: May 2014

Jane Chiodini investigates the risk to travellers from West Nile virus and dengue fever
Travel Health Forum celebrates 10th birthday
Authors: Chiodini Jane , Grieve Sandra
Published: May 2014

The annual meeting of the RCN's Travel Health Forum was held on Saturday 18 October. Jane Chiodini and Sandra Grieve report
Statins' role in reducing mortality
Authors: Pittard John
Published: May 2014

Dr John B Pittard discusses how to continue recent improvements in heart disease mortality and considers the experience of Allan
A new long-acting treatment for COPD
Authors: Scullion JE
Published: May 2014

The statistics for the progressive disease processes collectively known as chronic obstructive pulmonary disease (COPD) are bleak. COPD is becoming more prevalent and by 2020 will be the fifth most common cause of death and disability (National Heart, Lung and Blood Institute (NHLBI), 2001). COPD is an insidious disease in which genetic, constitutional, familial, behavioural, sociodemographic and environmental factors all predispose patients to chronic disease (COPD Guidelines Group, 1997). Of all the factors, the most important is cigarette smoking (Barnes, 1999). COPD is a major cause of morbidity and mortality, affecting 4% of men and 2% of women over 45 years of age. It causes 6% of male deaths and 4% of female deaths (Barnes, 1999).
To treat or not to treat acute diarrhoea?
Authors: Townend Mike
Published: May 2014

Mike Townend discusses the advantages and disadvantages of treating diarrhoea at home and abroad
Network to promote nurses' development
Authors: Felgate Sue
Published: May 2014

Sue Felgate has set up a forum with RCN support to enable practice development nurses to share ideas
Improving questionnaire response rates
Authors: Carr Jacqui
Published: May 2014

Jacqui Carr investigates the key consderations to designing effective questionnaires
CLINIC Lung Function Testing
Authors: Booker Rachel
Published: May 2014

In Part 2 of a 3-part series, Rachel Booker looks at how to ensure that the results obtained from peak flow meters and spirometry are accurate and meaningful.
New leader of practice nurses
Authors: Nutbrown Sue
Published: May 2014

Sue Nutbrown takes over as the new Chair of the RCN Practice Nurse Association in April. She spoke to Lucy Jolin.
Nurses embrace Agenda for Change
Authors: Didovich Karen
Published: May 2014

Following nurses' overwhelming vote in favour of the new pay and conditions structure, Karen Didovich considers the implications for practice nurses
Practical tools for diagnosing depression
Authors: Norris Olivia
Published: May 2014

Olivia Norris argues that practice nurses are best placed to diagnose patients with depression
Depression and self-care in people with diabetes
Authors: Johansson K Anna H
Published: May 2014

Depression is two to three times more common among people with diabetes. Anna Johansson discusses some ways to help patients with diabetes and depression improve their self-management
Dermatology Clinic
Authors: Watkins Jean
Published: May 2014

Psoriasis and seborrhoeic dermatitis of the scalp are common problems causing scaling and dandruff. Dr Jean Watkins explains how to distinguish and treat these two conditions.
Acute mountain sickness
Authors: Goodman Benny
Published: May 2014

Benny Goodman discusses how to help travellers avoid the risks of altitude sickness and presents two case studies
Organizing the next practice nurse conference
Authors: Howie Kate
Published: May 2014

Kate Howie explains what the Winchester 2004 practice nurses have done so far to prepare for next year's conference
The importance of being a registered professional
Authors: O'Brien Kirsty
Published: May 2014

In the wake of a woman's conviction for posing as a practice nurse, Kirsty O'Brien explains how to check that your NMC registration is valid
A stepwise approach to effective consultation
Authors: Pearce Linda
Published: May 2014

Linda Pearce explains how to use a stepwise approach to communicate effectively with patients
New multilingual database for diabetes
Authors: Misell Andy
Published: May 2014

Andy Misell outlines the purpose and contents of Diabetes UK's new database of diabetes resources in 32 community languages
HIV testing. Part 2: Pre- and post-test advice
Authors: Peate Ian
Published: May 2014

In the second of two articles Ian Peate looks at how practice nurses can counsel patients before and after HIV testing
Montezuma's revenge
Authors: Chiodini Jane
Published: May 2014

Jane Chiodini tells the story of a young man who fell ill while backpacking in Mexico and considers the implications
Preparing wounds for efficient tissue repair
Authors: Bentley Jenny
Published: May 2014

Jenny Bentley looks at how to ensure efficient tissue repair through preparation of the wound, and highlights the variety of available wound management products
Sun and skin
Authors: Chiodini Jane
Published: May 2014

Jane Chiodini investigates the risks posed by the sun to travellers to hot and snowy climates, and recommends some guidelines for protection
What to expect from the QOF reviews
Authors: Tinson Chrissy , Holland Amanda
Published: May 2014

From October to January, reviews will take place in general practices to assess progress towards achieving the targets they aspired to in the quality and outcomes framework (QOF). Chrissy Tinson and Amanda Holland explain the assessment process
Scaly feet: Keratoderma
Authors: Watkins Jean
Published: May 2014

A scale is defined as a flaking of the skin owing to increased loss from the stratum corneum. This may be caused by the production of abnormal keratin or keratin that is produced at an increased rate, as occurs, for example, in psoriasis. Damage to the stratum corneum also leads to scaling, and scaling may be associated with eczema and infections. In keratoderma, the horny keratin layer of the skin is formed normally but is not shed at the normal rate. As a consequence, there is a build-up of a thickened keratin layer of the skin that does not scale, but may create a similar effect of dry flaking skin. This problem may result from an underlying congenital abnormality affecting the skin or as the result of persistent pressure and trauma (du Vivier, 2002: 11).
A hydrogel that may help relieve sunburn pain
Authors: Wilkinson Eleanor
Published: May 2014

Eleanor Wilkinson assessed the use of a hydrogel dressing, ActiFormCool, to treat sunburn in two patients
Assessing and treating erectile dysfunction
Authors: Hallam-Jones Ruth
Published: May 2014

Ruth Hallam-Jones discusses the management of erection problems in men and considers the case of David
Resourcing clinicians for the patient safety culture
Authors: Parker Joanna
Published: May 2014

Joanna Parker explains the role and aims of the National Patient Safety Agency
Fever
Authors: Willcox Adrienne
Published: May 2014

In the second of our series on returning travellers’ ailments, Adrienne Willcox investigates the differential diagnosis of travellers who come home with fever
New guidelines for the management of COPD
Authors: Booker Rachel
Published: May 2014

Rachel Booker explores what is new in the NICE guideline for the management of chronic obstructive pulmonary disease (COPD), published in February
Navigating the choice of available COC pills
Authors: Calvin Melissa
Published: May 2014

Melissa Calvin looks at how to help women choose the most appropriate combined oral contraceptive (COC) from the great variety available.
Asthma in the new GMS: What do you need to do?
Authors: McAllister Judith
Published: May 2014

Judith McAllister outlines how practice nurses can help meet each of the asthma targets in the new GMS contract
Water hazards
Authors: Grieve Sandra
Published: May 2014

Sandra Grieve addresses water-borne diseases and water safety issues, and suggests some advice to help travellers prepare adequately for water-based hazards when abroad
Patient involvement
Authors: Martin Jeannett
Published: May 2014

The Health and Social Care Act 2001 (Section 11) makes it a statutory requirement to involve patients and the public at every stage of health care from developing strategy to the delivery of services. As a result of this, two very important new groups have been established: health care scrutiny committees and the patient and public involvement (PPI) forums, which have replaced the old community healthcare councils.
Reviewing the evidence for cranberry juice
Authors: Livesley Joan
Published: May 2014

Is there much evidence for using cranberry juice to treat urinary tract infections? Joan Livesley traces the dissemination of some uncertain research findings
Hearing loss and wax occlusion in older people
Authors: Rodgers Rosemary W
Published: May 2014

Rosemary Rodgers considers solutions for elderly people with ear problems and outlines methods to improve basic ear care
The role of practice nurses in mental health
Authors: Enright Aislinn , Manning Chris
Published: May 2014

Aislinn Enright and Chris Manning discuss the role of practice nurses in mental health and a new resource pack to support and enable positive practice
Spots around the eyes
Authors: Watkins Jean
Published: May 2014

Patients sometimes worry about things that may seem trivial. A small blemish, particularly if it is on the face and visible for all to see, can be a real problem. The patient may be concerned that it is the start of cancer, that it may be a manifestation of an underlying disease, or that it will spread and he/she will be too embarrassed to go out in public.
Practice nurse appraisal: A systematic approach
Authors: Styles Julia Ann , Burgham-Malin Margaret , Bayliss Sarah
Published: May 2014

Julia Ann Styles, Margaret Burgham-Malin and Sarah Bayliss discuss the new approaches to practice nurse appraisal
Using emollients and steroids in eczema
Authors: Ward Sue
Published: May 2014

Sue Ward explores the use of emollients and topical steroids for the treatment of eczema, and highlights the issue of patient concordance
Ticks and Lyme disease
Authors: Chalmers Charlotte , MacCallum Janis , Brown Jane , Anderson Ros
Published: May 2014

Ticks are prevalent in parts of the UK during the summer months. Charlotte Chalmers, Janis MacCallum, Jane Brown and Ros Anderson discuss the associated diseases and recommend a method of removal
Liberation and innovation in ancient Winchester
Authors: Martin Jeannett
Published: May 2014

Jeannett Martin reports on the debates and discussion at the 21st annual practice nurse conference, held 31 June to 2 July in Winchester, Hampshire
Sexual behaviour
Authors: Lang Sarah
Published: May 2014

Sarah Lang discusses the importance of sexual health when travelling and suggests ways to approach the subject with patients
HIV testing. Part 1: An introduction
Authors: Peate Ian
Published: May 2014

In the first of two articles on advising patients before and after HIV testing, Ian Peate looks at the epidemiology of HIV and at the reasons for testing
Challenging the role of practice nurses
Authors: Credland Nicky
Published: May 2014

Lucy Jolin talks to Nicky Credland about her time as a nurse for Operation Raleigh and her achievements as a diabetes specialist nurse
Depression after NICE
Authors: McCulloch Andrew
Published: May 2014

Depression is one of the costliest causes of ill health yet evidence suggests it is treated in a hitor-miss style. Depression is a spectrum of experience ranging from severe depression with a high risk of suicide to a prolonged state of mild but functional melancholy. This makes delivering a consistent response is difficult. So too does the fact that about 1 in 15 patients on a GP list experience some level of depression in any year.
Managing stress urinary incontinence
Authors: Anders Kate
Published: May 2014

Kate Anders explains the identification, diagnosis and management of stress urinary incontinence
Sharing management of neuroendocrine tumours
Authors: Bouvier Cathy , Hayman Alison
Published: May 2014

Cathy Bouvier and Alison Hayman consider the management of neuroendocrine tumours and sketch a brief outline of the practice nurse's possible role
Perspectives
Authors: Carrier Judith , Brassey Jon
Published: May 2014

The NLH Question and Answering Service was set up for primary care practitioners to ask any question related to their clinical practice. Below are two of the questions asked this month. For full answers and references please refer to website at www.clinicalanswers.nhs.uk .
Awareness differs by ethnicity and age
Authors: Gunaratnam Yasmin
Published: May 2014

Yasmin Gunaratnam reports on a survey which reveals differences in the awareness of breast health among different groups of women
Creating a new health-care practitioner
Authors: Paniagua Hilary , Callwood Ingrid
Published: May 2014

Hilary Paniagua and Ingrid Callwood explain the role and training of the new medical care practitioner, and consider the implications for practice nurses.
Mobile self-management
Authors: McWilliam Stuart
Published: May 2014

Hannah has lived with diabetes for 14 years, and has tried out a new system for monitoring her glucose control using mobile phone technology. Stuart McWilliam explains
Are older people with diabetes compliant or empowered?
Authors: Abbott Stephen , Gunnell Caroline
Published: May 2014

The National Service Framework for Diabetes sets the empowerment of patients as a standard. It interprets empowerment as self-management and partnership with professionals. A qualitative study of older people with diabetes found that the majority self-managed their diabetes in the limited sense of self-medication and observing dietary restrictions, and many monitored their blood glucose levels. Some ignored dietary advice, however. Information about diabetes could be helpful, but also frightening or confusing. Although some were extremely independent, several would have preferred more support from health professionals, finding self-management to be not empowering, but a burden. Patients who are not given a choice cannot be said to be empowered.
Which drug reactions should be reported?
Authors: Baldridge Catherine
Published: May 2014

Catherine Baldridge explains how the Yellow Card scheme for reporting drug side effects works and which adverse drug reactions nurses should report
Gatekeeping part 3: Results and practice recommendations
Authors: Cullen Julie
Published: May 2014

A lack of evidence for the skills and professional development support required by practice nurse ‘gatekeepers’ who undertake triage for patients requesting same-day access to primary medical care was identified in the first article in this series (Cullen, 2003). The second article (Cullen, 2004) followed the journey of this research, explaining how a qualitative approach, guided by modified grounded theory method, was adopted. This third and final article discusses the findings leading to the conclusion that a great deal of service provision in general practice is met through the practice nurse's gatekeeping role. A number of recommendations for practice are made.
Hepatitis A
Authors: Driver Carolyn
Published: May 2014

Carolyn Driver looks at the transmission of hepatitis A and how to advise people about the risks when travelling abroad
HRT and breast cancer: Is there an association?
Authors: Vickers Madge
Published: May 2014

Madge Vickers reviews the evidence on whether hormone replacement therapy (HRT) increases the risk of breast cancer
Red and spotty faces
Authors: Watkins Jean
Published: May 2014

Patients with blemishes on their faces tend to seek advice early. They are usually embarrassed by their problem and upset by the kindly (or otherwise) remarks of their friends and colleagues. Some of the symptoms that might bring patients to the surgery include spots, pustules or inflammation around the mouth or beard area. Alternatively, these symptoms are often noticed readily by the doctor or nurse when the patient presents.
A passion for travel and education
Authors: Jolin Lucy
Published: May 2014

Adrienne Willcox spoke to Lucy Jolin about her love of travel health and expanding the knowledge of fellow practice nurses
More education needed on weight and insulin
Authors: Cheyette Chris
Published: May 2014

Chris Cheyette argues that patients with impaired glucose tolerance or diabetes need more support and education to manage their weight because of the known benefits of life-style interventions and the potential for insulin and sulphonylureas to cause weight gain
Does your practice need a pneumonia clinic?
Authors: Riley Cate
Published: May 2014

From April age-related recommendations for pneumococcal vaccination become uniform throughout the UK. Cate Riley reviews the national advice
Malaria awareness
Authors: Chiodini Jane
Published: May 2014

Jane Chiodini reviews the guidance available on malaria prevention and outlines sources of advice for travel health advisers and travellers
Recognizing and managing osteoporosis
Authors: Worcester Gwen
Published: May 2014

Gwen Worcester looks at the diagnosis and management of osteoporosis and highlights a new pharmaceutical treatment
Discussing solutions to work incapacities
Authors: Williams Nerys
Published: May 2014

Nerys Williams highlights the importance of good communication with occupational health practitioners when caring for people who are unfit for work
Anne Mead: A diabetes passion
Authors: Mead's Anne
Published: May 2014

Anne Mead loves talking with patients and colleagues about diabetes. She spoke to Lucy Jolin
Learning disabilities: First impressions
Authors: Williams Laura , Davies Jill
Published: May 2014

Laura Williams and Jill Davies look at how practice nurses can help parents of children with learning disabilities access a range of important services
Environmental factors that trigger eczema
Authors: Ward Sue
Published: May 2014

Sue Ward considers the allergic triggers that may exacerbate atopic dermatitis (eczema)
Meningitis & diphtheria
Authors: Sinclair Jean
Published: May 2014

Jean Sinclair considers what advice can be provided to travellers concerning the risk of meningitis and diphtheria while abroad
Walk the talk to better community fitness
Authors: Parker Penelope , Angus Caroline
Published: May 2014

Penelope Parker and Caroline Angus explain the benefits of community-based walking programmes for patients with cardiovascular risk factors
Sharing expertise on health for life in Surrey
Authors: Martin Jeannett
Published: May 2014

Jeannett Martin reports on discussions at the National Practice Nurse Conference, held 22–24 June at the University of Surrey, Guildford
Looking to the future in Stirling
Authors: McGeoghegen Carolyn
Published: May 2014

Discussion at this year's SPNA annual conference focused on important professional and clinical developments. Carolyn McGeoghegan reports
The effects of university life on students' health
Authors: Massey Marie Therese
Published: May 2014

Marie Therese Massey discusses the effects of financial hardship on the health of students and suggests ways in which this could be tackled
Letter
Authors: MacKinnon Wendy
Published: May 2014

The removal of qualifications from the NMC Statement of Entry continues to cause disquiet. To have your say, please e-mail liam@markallengroup.com
Making more effective use of time
Authors: Vaughan Paul , Cross Sue
Published: May 2014

Paul Vaughan and Sue Cross explain the aims of the Working in Partnership Programme to improve nursing in general practice
Anne Cooper: Skill-mixer
Authors: Cooper Anne
Published: May 2014

Anne Cooper has been a practice nurse in Scotland for 25 years. She spoke to Liam Benison about her experience.
How to ‘immunize’ against depression
Authors: Bennett Wendy
Published: May 2014

Is depression like a ‘virus’? Can you ‘catch’ it? Will it attack and destroy someone's emotional immunity? Can you stop it multiplying and causing further ‘infection’? Martin Davies, a former community psychiatric nurse, who now specializes in depression and stress training, thinks so and he has written and illustrated a self-help cartoon book on the subject, Sod It! The Depression ‘Virus’ and How to Deal with It, which can be used by both patients and practice nurses.
Domestic violence: Asking the question
Authors: Lynch Lynn
Published: May 2014

Lynn Lynch discusses some new standards for recognizing and addressing cases of domestic violence that may present in primary care
Does her mother know?
Authors: Kerridge Tony
Published: May 2014

In the wake of the Sue Axon judicial review, Tony Kerridge considers the provision of sexual health advice to under 16s
Assessment of men's emotional problems
Authors: Watkins Jean
Published: May 2014

Jean Watkins looks at some of the reasons why signs of men's emotional problems may be difficult to recognize when they consult in general practice.
English smoking ban
Authors: Benison Liam
Published: May 2014

Contrary to expectations, the House of Commons voted by a margin of 200 to ban smoking in all enclosed public places in England except hospitals, residential care homes, prisons and hotel bedrooms on 15 February.
Adventure racing
Authors: Sinclair Jean
Published: May 2014

Jean Sinclair explains what a mountain marathon is and what advice or treatment you may need to give someone who is a participant.
Caring for gay men 2: A welcoming practice
Authors: Peate Ian
Published: May 2014

In the second of two articles, Ian Peate suggests some ways in which practices can become more welcoming to gay men and so offer equitable access to primary health care.
Improving respiratory diagnosis
Authors: Benison Liam
Published: May 2014

The third Airways Extra conference was held in Coventry on 28 March. Liam Benison reports.
Suzie Clements: Extending horizons
Authors: Clements Suzie
Published: May 2014

Suzie Clements is committed to helping practice nurses extend their roles into new areas. She spoke to Liam Benison.
Teaching better symptom control
Authors: Newell Karen
Published: May 2014

Karen Newell highlights a new campaign to help people with asthma understand what poor symptoms are and how to respond.
Clinical Q&A
Authors: Carrier Judith , Brassey Jon
Published: May 2014

What is the best way to screen for diabetic peripheral neuropathy and what is the minimal testing that should be done as part of a diabetic annual review in relation to testing circulation and neurology in the legs?
Working toward a weight wise generation
Authors: Cooke Rachel
Published: May 2014

In Summer 2006, the British Dietetic Association will launch a campaign to tackle the rising tide of obesity in adolescence. Rachel Cooke looks at the reasons for concern and some practical ways to address the problem.
Nutritional advice before and during pregnancy
Authors: Williamson Claire
Published: May 2014

Claire Williamson outlines the current dietary recommendations for women before and during pregnancy, and considers some of the evidence behind them.
How to recognize lymphoedema
Authors: Williams Anne F
Published: May 2014

Anne Williams examines the signs, symptoms and physiology of lymphoedema.
Hepatitis B
Authors: Evans Norma
Published: May 2014

Norma Evans reviews the transmission of hepatitis B and looks at vaccination.
Dignity is a core value
Authors: Beckwith Sue
Published: May 2014

It is with mixed feelings that I contemplate the latest government watchdog appointed with the remit ‘to make dignity in care a priority’ (Department of Health, 2006a). Care Services Minister, Liam Byrne, speaks of care for older people being delivered with ‘the dignity they deserve’ and free from ‘abuse’ (DH, 2006b).
Travelling home
Authors: Wilcox Adrienne
Published: May 2014

Adrienne Willcox considers the key aspects of a consultation with a returned traveller, with reference to the case of Justin, who has recently come home from Thailand
Anterior uveitis
Authors: Watkins Jean
Published: May 2014

This elderly man had a red right eye (Figure 1). He had bought a simple eye ointment and had for several days been applying it to the eye but had obtained no relief. Eventually he attended the surgery asking for something to ‘help his conjunctivitis’. On further questioning, he said that the eye had been red and watering, he found it more troublesome in situations of bright light, and he admitted that the eye ached and that his vision had become somewhat blurred.
People with dementia: Not mad and not bad
Authors: O’Connor Chris , Isenman Moira , Hadland Sue
Published: May 2014

Dementia is often slow to be recognized. Chris O’Connor, Moira Isenman and Sue Hadland highlight a new resource for health professionals
Including pneumococcal vaccine in the childhood schedule: Primary health professionals'; views
Authors: Chantler Tracey , Yu Ly-Mee , Newton Sarah , Diggle Linda
Published: May 2014

Routine use of a heptavalent pneumococcal conjugate vaccine (PCV7) in infants in the United States has resulted in a decrease of pneumococcal disease. In the UK the Department of Health has announced plans to immunize all children against pneumococcal disease.

Aim: To evaluate primary health professionals’ knowledge of pneumococcal disease and their opinions about the acceptability of the inclusion of PCV7 in the routine childhood vaccine schedule.

Methods: A postal survey was conducted in Thames Valley Strategic Health Authority, UK. An anonymous questionnaire containing knowledge and attitudinal questions was sent to 2750 primary care professionals involved in immunization. This included general practitioners (GPs), practice nurses and health visitors.

Results: A total of 543 primary health professionals responded and their mean ‘pneumococcal disease and vaccination knowledge score’ was 60% (SD 16.61%). The incidence of pneumococcal disease was perceived to be highest in the elderly; only 14% (71/543) recognized it was highest in infants. Although 70% (372/531) thought pneumococcal disease presented a serious risk for babies, 55% were unsure about the necessity of adding PCV7 to the routine schedule and 7% considered it unnecessary. Practice nurses were most uncomfortable about administering three injections simultaneously (P<0.001); and more likely to believe that giving three injections would cause a baby too much pain and distress (P<0.001).

Conclusion: Primary health professionals’ are unconvinced of the necessity for infant pneumococcal vaccination and concerned about administering multiple injections simultaneously. Multi-faceted educational strategies addressing both attitudinal and knowledge barriers need to be developed to facilitate the introduction of PCV7.
Integrating health care assistants
Authors: Vaughan Paul
Published: May 2014

Paul Vaughan highlights new resources available to help practice nurses and their colleagues develop the benefits of the HCA's role
Heroes talk, listen and inspirea
Authors: Marshall Sally
Published: May 2014

Sally Marshall provides a postscript to the 2006 RCN Practice Nurse Conference, held at Sopwell House, St Albans from 5 to 7 July
Assessment of cardiometabolic risk
Authors: Watson Jan
Published: May 2014

Jan Watson reviews the assessment of cardiovascular risk according to recommendations in the Joint British Societies' guidelines
A new infant schedule
Authors: Chantler Tracey , Ford Karen J
Published: May 2014

Changes to the childhood immunization schedule came into effect on 4 September. Tracey Chantler and Karen Ford discuss one of the key changes: the introduction of a new pneumococcal conjugate vaccine
Bipolar disorder: How to recognize the ‘too well’
Authors: Hunt Neil
Published: May 2014

Neil Hunt explains how to recognize bipolar disorder, the symptoms of which may remain masked for years or mistaken for other illnesses
How to define and manage difficult patients
Authors: Lakasing Edin
Published: May 2014

Edin Lakasing categorizes different types of ‘difficult’ patients and considers some ways to overcome the barriers to caring effectively for them