bluuebunny/crossref_metadata_2025 huggingface dataset:
Rivaroxaban: a novel anticoagulant for the treatment of DVT
Authors: Haastrup Margaret , Williams Helen
Published: May 2014

Rivaroxaban is an oral anticoagulant licensed for the treatment of acute deep vein thrombosis (DVT), and prevention of recurrent DVT and pulmonary embolism (PE) following an acute DVT in adults. It is also licensed for the prevention of stroke and systemic embolism in adult patients with additional risk factors with non-valvular atrial fibrillation. In addition, rivaroxaban has been licensed in the UK for the prevention of venous thromboembolism (VTE) in adult patients undergoing hip or knee replacement surgery. The National Institute for Health and Excellence (NICE) has approved rivaroxaban as a treatment option for all its licensed indications ( NICE 2012a , b , c ). Rivaroxaban is a highly selective direct factor Xa inhibitor with oral bioavailability. Inhibition of factor Xa interrupts the intrinsic and extrinsic pathway of the blood coagulation cascade, inhibiting both thrombin formation and development of thrombi. Rivaroxaban does not inhibit thrombin (activated Factor II) and has effects on platelets have been demonstrated ( Bayer, 2012 ). Rivaroxaban is administered as a fixed dose regimen, and unlike vitamin K antagonists such as warfarin it does not require regular laboratory monitoring and has no known food, with few drug interactions.
Nutritional supplements: benefits and risks
Authors: Webb Geoffrey P
Published: May 2014

Geoffrey Webb reviews the benefits and risk of taking nutritional supplements and identifies groups of people who are most likely to benefit from them.
Providing respite care
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst discusses the importance of respite care for both clients and carers and discusses the role of care homes.
A professions allied to medicine training team for care staff
Authors: Notman Gillian
Published: May 2014

Gillian Notman describes an innovative service that has been developed to promote quality of life for residents and to improve the support from the professions allied to medicine to nursing and residential homes within the Greater Glasgow Health Board boundary.
Selecting and fitting Activa compression hosiery
Authors: Hampton Sylvie
Published: May 2014

In the second of two articles describing compression hosiery, Sylvie Hampton focuses on the methods of assessment and practical application of Activa stockings.
Exploring the therapeutic effects of acupuncture
Authors: Myatt Anita
Published: May 2014

Anita Myatt looks at the myths and techniques of the ancient art of acupuncture, outlining its administration, benefits and side-effects.
Falls prevention
Authors: Nazarko Linda
Published: May 2014

This article explains how specialist falls services can help reduce the risk of resident falls.
Continence: Catheter management
Authors: Nazarko Linda Nazarko
Published: May 2014

Catheterization is not always necessary and can often cause discomfort. Linda Nazarko discusses using evidence-based care to diagnose why a catheter may leak and how best to treat this common problem.
Best practice guideline for medication-related dysphagia
Authors: Griffith Richard
Published: May 2014

Consensus guidance for managing dysphagia has been developed to reflect the problems that nurses and care staff encounter when managing the growing numbers of residents who have difficulties swallowing their medication.
A comforting touch: enhancing residents' wellbeing
Authors: Newson Pauline
Published: May 2014

A resident's comfort is central to wellbeing. Comfort can extend beyond physical, to include emotional and spiritual needs. Pauline Newson discusses the importance of understanding these various levels and types of needs and the positive effects of a ‘comforting touch’.
A closer look at the anatomy of the gastrointestinal tract
Authors: Burch Jennie
Published: May 2014

By gaining a better knowledge of the workings of the gastrointestinal tract, nurses and care assistants are better placed to recognize related problems. Jennie Burch provides an overview.
Caring for the diabetic foot: recognition and management
Authors: Edmonds Michael
Published: May 2014

Developing an understanding of the natural history of the diabetic foot can aid fast diagnosis and intervention. Michael Edmonds and Audrey Edmonds describe the stages and appropriate intervention.
Achieving concordance with compression therapy
Authors: Brown Annemarie
Published: May 2014

Compression therapy helps leg ulcers to heal and reduce or maintain the swelling from chronic oedema, but concordance can be a problem. Annemarie Brown explains how you can help.
Is physical restraint ever necessary in your workplace?
Authors: Paterson Brodie , Leadbetter David , Martin Alan , Steele George
Published: May 2014

Restraint is something nobody likes to think about having to do, but if the need for it can be foreseen, training is necessary. However, as the authors explain, training is highly variable
CQC excellence scheme will replace the star rating awards
Authors: Farrell Zoe
Published: May 2014

Zoe Farrell Reports on the plans for the CQC's excellence scheme, which will replace the star ratings awards.
Dementia care: spiritual and faith perspectives
Authors: Jolley David , Moreland Neil
Published: May 2014

Care home residents may use religiosity and spirituality as a coping resource through illness and disability. David Jolley and neil Moreland explain how they affect quality of life and how attending to it can enhance care.
An end of life care training programme from hospice staff
Authors: Lansdell John , Mahoney Mary
Published: May 2014

With 17% of deaths occurring in care homes where training may be inadequate, John lansdell explains how training from hospices based around skills for Health and skills for Care competencies can improve standards.
Management options for faecal incontinence
Authors: Woodward Sue
Published: May 2014

Sue Woodward outlines the different ways in which bowel leakage, stool consistency and difficulty emptying can be combated to ensure a better quality of life for individuals in a home
Addressing common stoma complications
Authors: Gardiner Angela
Published: May 2014

This article outlines common problems when a conduit is formed to enable excretion via a drainable appliance from the gastrointestinal or urinary tract and how staff can support residents
The mealtime experience: dignified and respectful dining
Authors: Duke Tony
Published: May 2014

Eating and drinking is an important part of everyday life. Tony Duke explains why staff involvement and support is essential to ensure each mealtime passes smoothly and that residents receive appropriate food and refreshment to meet their needs
Constipation: causes, assessment and management
Authors: Gardiner Angela
Published: May 2014

Angela Gardiner provides an overview of normal physiological processes of defaecation and presents the signs and symptoms of constipation. Assessment and management options can enhance quality of life for sufferers of constipation
HSC 3048: Support individuals at the end of life—part 1
Authors: Green Danielle
Published: May 2014

This optional unit assesses the health and social care worker's ability to provide support throughout end-of-life care, explains Danielle Green
Common causes of dyspepsia and the difficulties of diagnosis
Authors: Elliot Dawn
Published: May 2014

The diagnosis and treatment of dyspepsia symptoms is difficult to quantify. However, being aware of the signs and symptoms, particularly of those classed as alarm symptoms, will aid in decision-making about initial treatment or direct to test referral
The Care Bill—designed to improve the delivery of services
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst explains the impact of the Care Bill on the delivery of quality care and support for older people living in care homes and how providers can prepare for future inspections by the Care Quality Commission
The CQC strategy: for better or for worse
Authors: Elaswarapu Rekha
Published: May 2014

‘The commitment to better engage with the public and giving people’s views the due importance in regulation is a welcome approach.’
The correct use of stoma skin protectors and appliances
Authors: Black Pat
Published: May 2014

Pat Black recaps on the basic knowledge staff need to have of stoma care, particularly regarding older residents, and the support that needs to be given to those who may no longer be able to remember how to change appliances or are physically unable to do so
Consulting with local authorities on fee setting for services
Authors: Donohue Pete
Published: May 2014

Prospective residents may have the choice of several care homes that suit their health-care needs, however, the cost of the accommodation is usually a major factor that prevents local authorities from sanctioning the move to some services, as Pete Donohue explains
Take your school to a hire level Renting out your facilities
Authors: Maiden Andre
Published: May 2014

Most of the halls, gymnasia and other rooms in your school have the potential to be let out. In addition, you may have other facilities including kitchens, dining halls, libraries, conference rooms, allweather pitches and swimming pools.
Alma mater parties Holding a school reunion
Authors: Maiden Andrew
Published: May 2014

Reunions are a good idea for your school for several reasons. Most pupils are keen to catch up with former friends and teachers and it provides your school with an opportunity to raise money from interested parties.
Each to her own
Authors: Saunders Diana
Published: May 2014

By the time you read this I am sure that you will be familiar with the final version of the transitional arrangements. They have, at last, been decided by the UKCC, and the ENB has decided how they will be enforced.
The future is in your hands
Authors: Richards Sue
Published: May 2014

The final transitional arrangements are to be implemented by the ENB. Sue Richards comments on how they will affect the practice nurse.
Chronic fatigue syndrome
Authors: Welsh Liz
Published: May 2014

Chronic fatigue syndrome is a serious disorder the existence of which used to be doubted. Liz Welsh explains how to to tell if a patient has it
Assessing incontinence
Authors: Carr Brigid
Published: May 2014

It is important for the practice nurse to interact with the family positively and sympathetically when dealing with daytime incontinence in children, says Brigid Carr.
Managing diabetes: Troublesome teens
Authors: Waring Julie
Published: May 2014

Living with diabetes involves a regular, controlled lifestyle — which in teenagers can be difficult. Julie Waring suggests how the adolescent diabetic is managed.
Quality in context
Authors: Whittington Dorothy
Published: May 2014

Dorothy Whittington traces the origins and development of health care quality assurance and its implications for practice nursing.
Home alone — with dementia
Authors: Keady John
Published: May 2014

A new report came out at the end of last year looking at people with dementia living in sheltered housing. John Keady examines the implications of this for practice nurses.
The road to quality
Authors: Hobbs Susan
Published: May 2014

Quality may be a worthwhile goal in nursing, but competence is the means to achieve it. Sue Hobbs discusses the ways of reaching quality in practice nursing.
Incontinence after childbirth
Authors: Wells Mandy , O'Reilly Carole
Published: May 2014

The pelvic floor and urethral sphincters play an important part in maintaining continence after childbirth. The pelvic floor consists of the levator ani muscles and supports the external urinary and anal sphincters. The special feature of the sphincters is that they are in a continuous slight tonic contraction (Gowers, 1877; Floyd and Walls, 1953) which aids continence.
Anthroposophy — the missing link?
Authors: Jardine Alexandra
Published: May 2014

Park Attwood is a clinic which claims to stimulate the natural healing processes through the tenets of anthroposophy. Alexandra Jardine visits this clinic with a difference.
Asthma: The physiology
Authors: Thompson Sue
Published: May 2014

Sue Thompson describes the physiology and pathophysiology associated with asthma, and discusses the concepts of patient education and self-management.
Nurse Prescribing: Are you Ready?
Authors: Blatt Barry
Published: May 2014

Nurse prescribing is the greatest revolution in nursing of the decade. Barry Blatt visited the pilot site in Taunton to see what the future holds.
Walk-in Clinic: Heartburn
Authors: Fisher Pam , Tyler Mark
Published: May 2014

Heartburn is a common problem with symptoms that if untreated can become serious. Practice nurses are ideally placed to help patients, as Pam Fisher and Mark Tyler explain.
Book Reviews
Authors: Archer Trudie , Wagg Ann , Cooper Maggie
Published: May 2014

Burns trauma guide clear on protocols

No nonsense cancer update

Blood pressure advice at your fingertips
Medical Treatments in Infertility
Authors: Atkinson Jane
Published: May 2014

A number of treatments are available to couples to help them conceive, as Jane Atkinson explains.
Colorectal Cancer Screening
Authors: Scanlon Noel , Weedon Sue
Published: May 2014

If caught early, colorectal cancer can be sucessfully treated, but patients must be properly screened. Noel Scanlon and Sue Weedon explain how.
Holistic Approaches to Diabetic Education
Authors: Turner Eileen
Published: May 2014

Health professionals often treat the disease, rather than the person. Eileen Turner looks at how an alternative, holistic attitude can help people with diabetes.
Diagnosis and Treatment of Constipation
Authors: Walker Robert D
Published: May 2014

The British traditionally have an obsession with their bowels. Remedies for constipation have always been a feature of family medical guides and old textbooks of Medicine. Thomas Culpepper's Complete Herbal and English Physician, 1826 edition, suggests a mixture of ‘Grains of Paradise, long pepper, turmeric, and two ounces of steel filings mixed in honey’ as a cure for ‘those whose courses are stopped’! The current edition of the OTC Directory lists 33 different laxative preparations that are available without prescription and MIMS lists 43 preparations under the section dealing with the treatment of constipation. In many cases the patient's description of the symptoms does not justify the diagnosis, so a careful assessment of bowel habit must be made before considering the management of constipation.
Causes and Consequences of Hypertension
Authors: Watson Roger
Published: May 2014

Hypertension has complex origins and can result in a number of serious conditions. Roger Watson explains.
A Challenge for us all: Helping People Change
Authors: Doherty Yvonne , Ashworth Polly
Published: May 2014

Polly Ashworth and Yvonne Doherty explain how to help hypertensives reduce blood pressure through a healthier lifestyle.
Walk-in Clinic Scabies
Authors: Fisher Pam
Published: May 2014

Scabies can affect any age group, and is commonly presented in general practice
Internet privacy — RIP?
Authors: Lau RKW
Published: May 2014

On 2 October 2000 the Human Rights Act (HRA) 1998 came into force in the UK. These rights are protected by the European Convention on Human Rights. While most of us are unlikely to be directly affected by this legislation, the Regulation of Investigatory Powers Act (RIPA), which was delayed in its passage through the House of Lords and will come into effect later in October 2000, will have farreaching official powers to monitor Internet activities and threatens to produce an online ‘Big Brother’ state.
ECT: survivors in the driving seat
Authors: Mills Hannah
Published: May 2014

A former recipient of ECT, Hannah Mills, presents a research-based and personal perspective on why this therapy gives her cause for concern
Returning travellers
Authors: Fisher Pam , Holmes Peter
Published: May 2014

Travellers can present with a variety of symptoms, indicating rare tropical diseases or more familiar complaints
Maleria: Part 2
Authors: Howell Karen
Published: May 2014

In the second article in a two-part focus on malaria, Karen Howell investigates clinical features, control measures and the precautions that travellers can take to prevent infection.
In Shipman's wake
Authors: Lakhani Mayur K
Published: May 2014

The activities of the former Dr Harold Shipman were truly horrific. What are the implications for general practice?
Taking risks with coronary heart disease
Authors: Peate Ian , Gault Christine
Published: May 2014

Ian Peate and Christine Gault argue that men's risk-taking behaviours leave them vulnerable to heart disease. Increased awareness of the complex social factors that affect men's health can improve the delivery of health care to men
Effecting prevention through dietary change
Authors: Mayor Susan
Published: May 2014

Susan Mayor argues there is a growing body of evidence to show that a dietary change can reduce the risk of colorectal cancer and that practice nurses are in a good position to provide good dietary advice
Prevention in practice: A management checklist
Authors: Long Sheila
Published: May 2014

In the second of two articles, Sheila Long explains how to use the Action for Stroke Group's checklist to help manage stroke patients and prevent further vascular events
Is meningitis a disease of the past?
Authors: Betts Helen
Published: May 2014

The meningococcal group C vaccination programme is proving to be an outstanding success. The media have reported a 90% decrease in cases of meningococcal group C disease (Irwin 2001) since the vaccine was launched in November 1999. However, this success may mislead people to assume that meningitis is becoming a disease of the past. Statistics show that other strains of meningitis bacteria continue to cause morbidity and mortality in children and adults (Figure 1). Therefore, this article reviews the identification, diagnosis and management of community-acquired meningitis and emphasizes the need to remain vigilant for the signs and symptoms of the disease.
Asthma Clinic
Authors: Weller Trisha , Walker Samantha
Published: May 2014

Jake's recurring summer hay fever is triggered by pollen and accompanied by wheezing and asthma symptoms. Trisha Weller and Samantha Walker discuss the best method of treatment.
Can you identify the dermatological complaint?
Authors: Watts Jane , Peters Jill
Published: May 2014

A 24-year-old woman was referred to the dermatology clinic with areas of depigmentation on her neck. A year earlier she had noticed a small area under her chin. This had gradually spread around the neck. On examination she had a small but similar patch on her left leg and another on her back. The areas were flat and not scaly; the skin texture felt normal. The lesions were not painful, but caused her much anxiety and distress because the affect on her appearance made her self-conscious and affected her social life. Questioning revealed that her maternal aunt had similar lesions on her arms, but kept these areas covered and most people were unaware of them.
Dengue fever
Authors: Howell Karen
Published: May 2014

Karen Howell explains the transmission and clinical features of dengue fever, which has increased in prevalence and gained similar status to malaria as an important international public health concern.
CLINIC Respiratory
Authors: Weller Trisha , Walker Samantha
Published: May 2014

Matthew is a 10-year-old boy who presents with a rash after eating a biscuit containing peanuts. His history of asthma makes him susceptible to peanut allergy.Trisha Weller and Samantha Walker discuss the implications.
Prescribing training: Prospects and eligibility
Authors: Wakinson Chris
Published: May 2014

The government has issued guidance on training for nurse prescribers, but who will be eligible? Chris Watkinson investigates.
Drug interactions: An introduction
Authors: Hackett Elizabeth
Published: May 2014

Elizabeth Hackett discusses drug interactions that nurses may encounter when prescribing or using patient group directions. She identifies some common interactions and some drugs that require special attention. Then test your knowledge of five common interactions.
Osteoporosis and fracture prevention
Authors: Elliott Mary
Published: May 2014

Mary Elliott discusses how practice nurses can intervene to help patients make lifestyle changes to reduce the risks of fractures and/or osteoporosis
A view from Scotland
Authors: Cooper Anne
Published: May 2014

The advent of a new GP contract in April 2003 will probably change the ethos of general practice. It is likely we will see the end of staff budgets. In theory, this should allow for more flexible use of funds and offer practice nurses opportunities to further extend their roles. But it should not be allowed to limit practice nurses to tasks such as telephone triage and chronic disease clinics alone. While these tasks are important, practice nurses need to keep providing holistic care. We are not substitutes for a lack of GPs.
Preventing and treating acute episodes of COPD
Authors: Britton Mark
Published: May 2014

Acute episodes or exacerbations of chronic obstructive pulmonary disease (COPD) place a significant burden on health care services. Dr Mark Britton argues the case for prevention and rapid symptom assessment
Answers to Dermatology Picture Quiz 17
Authors: Watts Jane
Published: May 2014

1 The diagnosis is Vitiligo. Vitiligo is a depigmenting disorder of the skin characterized by patchy loss of colour. It affects 2% of the population worldwide. The patches on the skin are caused by loss of melanocytes and can be large or small. These patches are always whiter than the rest of the skin. Vitiligo can also cause white patches in the hair, including the eyebrows, eyelashes, beard and body hair. Vitiligo doen not affect general health but the psychological effects can be devastating.
Letters
Authors: Cox Carol , Ledger Dorothy
Published: May 2014

Readers have answered calls in the June issue to respond to the consultation document on supplementary prescribing.A selection of responses is printed here and two letters to the editor appear overleaf presenting perspectives from clinical practice and academia.
Strategies for effective addiction management
Authors: Westwood Chris
Published: May 2014

Chris Westwood discusses the advantages of a holistic approach to managing addiction in general practice and recommends some strategies to improve addicts' motivation to change.
CLINIC Diabetes
Authors: Beckwith Sue
Published: May 2014

Drivers with diabetes need to meet special legal requirements. Charles is a lorry driver who needs to convert to insulin therapy to control his type 2 diabetes. Sue Beckwith looks at how to manage this transition.
Emollients' importance in eczema management
Authors: Rolfe Gill
Published: May 2014

Gill Rolfe discusses the treatment of atopic eczema (AE) and advocates educating patients in the continual use of emollients
Decontaminating instruments
Authors: Riley Jackie , Anderson Deidre
Published: May 2014

The effective decontamination of surgical instruments reprocessed in general practice is as important as in any other health-care setting, and public health concerns about the prevention of health-care associated infections are rising. As the use of more complex equipment and minor surgery increases, the failure to decontaminate adequately can lead to cross-infection with bacteria and/or viruses, including blood-borne ones (McCance et al, 1986; Overend et al, 1992).
Assessing opportunities for distance learning
Authors: Kennedy Susan
Published: May 2014

Susan Kennedy looks at the potential benefits of distance learning and considers course selection and some of the programmes relevant to practice nurses
Decontaminating the environment
Authors: Riley Jackie
Published: May 2014

General practice is often the first contact the public has with the health service. The risk of infection being transmitted in general practice is related to the volume of people using the facilities. The increase in investigations and invasive procedures, including minor surgery, has added to the risk (Lawrence and May, 2002).
Practice nurses' role in assessing male infertility
Authors: Peate Ian
Published: May 2014

Ian Peate investigates the factors that contribute to infertility in men and ways that nurses can assist men who are affected
Treating hand injuries in remote workplaces
Authors: Allan David J
Published: May 2014

David J Allan discusses the special requirements of treating hand injuries on North Sea oil rigs
The lifelong care needs of women with epilepsy
Authors: Greenhill Lyn , Betts Tim
Published: May 2014

Lyn Greenhill and Tim Betts argue that epilepsy creates specific needs for women with the condition, who need special support throughout their lives
An antidepressant that improves sleep
Authors: Wade Alan G , Daniels Louise
Published: May 2014

Dr Alan G Wade and Louise Daniels discuss the benefits of using antidepressants in primary care
Intervening early in osteoporosis
Authors: Davidson Lou
Published: May 2014

Osteoporosis can be prevented if it is recognized early and appropriate treatment and advice are given. Lou Davidson looks at Mrs Heartlift's experience
Free drugs and free will
Authors: Benison Liam
Published: May 2014

The Welsh Assembly Government (2003) is proposing to phase out rescription charges on all medicines by 2007. From 1 October the prescription price will fall by £1. Most of the nurses I spoke to at our most recent Primary Care Roadshow in Cardiff were unaware of this policy. But most thought it a positive step, chiefly because the current regime is inequitable: certain patients are eligible for free prescriptions (e.g. diabetics) but others, such as those with asthma, are not. In the experience of many nurses, asthma patients in particular often fail to buy the inhalers they need because they cannot afford them.
Urticaria and erythema multiforme
Authors: Watkins Jean
Published: May 2014

Both urticaria (hives) and erythema multiforme are conditions that frequently present in the surgery. The patient complains of sudden onset of a rash. The sometimes florid and bizarre rash of erythema multiforme can be confused with that of urticaria. If care is taken in the history taking and examination it should be possible to make the right diagnosis and advise the patient about immediate management and ways in which he/she might be able to avoid a recurrence.
Advising HIV-positive mothers
Authors: Wall Alison
Published: May 2014

Susan is a 22-year-old, HIV-positive mum who needs advice on immunization and other issues. Alison Wall explains why interdisciplinary communication is important
Eileen Munson: Limelight on Wales
Authors: Munson Eileen
Published: May 2014

Eileeen Munson is passionate about the interests of practice nurses in her home country of Wales. She spoke to Lucy Jolin
Childhood vaccination: Managing the changes
Authors: Willcox Adrienne
Published: May 2014

Adrienne Willcox reviews the new vaccines and changes to the childhood immunization schedule which came into effect on 27 September
Managing asthma and allergy in schoolchildren
Authors: Cross Sue
Published: May 2014

Sue Cross provides some practical advice to give parents and carers of schoolchildren with asthma
A framework for fairer employment in Scotland
Authors: Cooper Anne
Published: May 2014

Anne Cooper outlines a Framework published in Scotland intended to help gain access to Agenda for Change for practice nurses
Stroke prevention in general practice
Authors: Jones Amanda
Published: May 2014

Amanda Jones considers the latest guidelines on secondary prevention of stroke and the implications for the practice nurse role
Antihistamines' additional effects
Authors: Wood Stuart F
Published: May 2014

Brad's ‘hay fever’ symptoms have worsened but he needs to be fit for work. Jill, his practice nurse, suggests a change of antihistamine. Stuart Wood investigates
The control of lipids with a statin
Authors: Turner Alison , Dock Pembroke
Published: May 2014

Tony's cholesterol is only slightly above target, but prescribing a statin, in addition to life-style advice, may help control his lipid levels. Alison Turner explains
Smoking cessation: Helping smokers quit under the new GMS
Authors: Siddall Rhonda
Published: May 2014

Rhonda Siddall reports on some ways to achieve the 87 quality points for smoking cessation in the new GMS contract
COPD and the new GMS: Part 2
Authors: Booker Rachel
Published: May 2014

In the second part of this series on management of COPD under the new GMS contract, Rachel Booker considers the value of smoking cessation to Pete
High altitude
Authors: Driver Carolyn
Published: May 2014

Carolyn Driver explains how to assess the health risks of travel at high altitude
Developing the role of health care assistants
Authors: Bates Mavis
Published: May 2014

Mavis Bates reveals what her practice has done to ensure that health care assistants receive appropriate training and role development
Improving the quality of health services
Authors: Tinson Chrissy , Holland Amanda , Illsley Sarah
Published: May 2014

Chrissy Tinson, Amanda Holland and Sarah Illsley explain their roles as quality improvement facilitators
The glycaemic index and its use
Authors: Beckwith Sue
Published: May 2014

Karen has type 2 diabetes and needs to lose weight. She wonders if understanding the glycaemic index (GI) of food products might help. Sue Beckwith investigates
The recognition and treatment of the red eye
Authors: Watkins Jean
Published: May 2014

Dr Jean Watkins surveys a number of problems that present as a red eye, some of which need urgent referral to a specialist
Janet Langhorne: Conference ambition
Authors: Langhorne Janet
Published: May 2014

Lucy Jolin talks to Janet Langhorne about the process of organizing next year's annual Practice Nurse Conference in Guildford, Surrey.
Nurses need more training in nutrition
Authors: Jenkins Alison
Published: May 2014

Alison Jenkins argues that providing more training in nutrition to practice nurses would help tackle the obesity epidemic
Liquid-based cervical cytology: An update
Authors: Cooper Maggie
Published: May 2014

Maggie Cooper provides an update on liquid-based cervical cytology which is slowly being implemented across the UK under the NHS Cervical Screening Programme
A toolkit for professional development
Authors: Postle Diane , Upsall Pat , Watkins Maggie
Published: May 2014

Diane Postle, Pat Upsall and Maggie Watkins outline the aims of a resource to help practice nurses with professional development planning.
Travelling with children
Authors: Skeet Joyce
Published: May 2014

Joyce Skeet reviews key considerations for travelling with children and paediatric indications for immunization and malaria prophylaxis
Managing psoriasis as part of a team
Authors: Smith Brenda
Published: May 2014

Brenda Smith explains how to work with specialist nurses to reduce the pychological and physical impact of psoriasis on patients
Jane Bickerton: a varied road
Authors: Bickerton Jane
Published: May 2014

Jane Bickerton's career has taken her from London's East End to Atlanta, Georgia, and back again. She spoke to Lucy Jolin
The National Rheumatoid Arthritis Society
Authors: Bosworth Ailsa , Oliver Susan
Published: May 2014

Ailsa Bosworth and Susan Oliver explain the objectives and achivements of the NRAS and how the organization can help practice nurses care for patients with RA
Evidence-based care of the obese child
Authors: Aubrey Sophie
Published: May 2014

In the second article in this three-part series, Sophie Aubrey discusses assessment, diet, behaviour and psychological factors in the management of obese children
Implications of screening for colorectal cancer
Authors: Steele RJC
Published: May 2014

Professor RJC Steele discusses the implications of a national colorectal cancer screening programme for practice nurses
The nurse's role
Authors: Willcox Adrienne
Published: May 2014

Adrienne Willcox asks what a practice nurse is trying to achieve during a travel health consultation
Mixed messages and minefields for the young
Authors: Padbury Vicky
Published: May 2014

Vicky Padbury considers the barriers to access of sexual health services that young people face, and how practice nurses may be able to help address this problem
Enfuvirtide: The first fusion inhibitor for HIV
Authors: MacFarlane Emma
Published: May 2014

Emma MacFarlane explains the action of a new antiretroviral for HIV and considers the nurse's role in patient education and support
Folic acid and health: What is known?
Authors: Buttriss Judy
Published: May 2014

Judy Buttriss reviews the current knowledge about how folate, or folic acid, may protect against a number of diseases and considers the potential benefits of supplementation
An overview of treating lymphoedema
Authors: Wigg Jane
Published: May 2014

Jane Wigg introduces some of the treatment options available for lymphoedema and their role in its management
Lip lesions
Authors: Watkins Jean
Published: May 2014

When a patient walks into the surgery, his/her lips are always on view. Patients may arrive with a specific complaint for which they are seeking advice or, if the nurse or doctor is observant, he/she may notice some abnormality themselves. Some of these problems may seem so trivial that the patient does not feel the need to discuss them but, from the medical point of view, it may be possible to offer advice that will at least render the patient more comfortable. Sometimes, however, action can be initiated that may save the patient more troublesome or serious consequences. Lacerations of the lip, infections, swollen and dry lips, non-healing lesions and vascular lesions are some examples of lip conditions which will be discussed in this article.
Socrates, sex and chikungunya
Authors: McGeoghegan Carolyn
Published: May 2014

Carolyn McGeoghegan reports on discussions at the Scottish Practice Nurses Association annual conference held in Stirling on 10 May
Brown pigmented lesions
Authors: Watkins Jean
Published: May 2014

Increased public awareness of sun damage and the risks of development of skin cancers can lead patients to be concerned about brown discolouration of the skin.
Addressing fraud in general practice
Authors: Stone Wayne , Willis Matthew
Published: May 2014

Fraud is a problem that can occur in any workplace and the NHS is no exception. Wayne Stone and Matthew Willis look at efforts to reduce its impact in general practice
Lynn Gudgin: Strategic thinker
Authors: Gudgin Lynn
Published: May 2014

Lynn Gudgin is a member of the organizing committee for the 2006 Hertfordshire practice nurse conference. She spoke to Liam Benison
‘It's probably a virus.’ Knowing the difference between microbes
Authors: Winter George
Published: May 2014

George Winter explains the difference between bacteria, viruses, protozoa and fungi in the first in a series of articles on the importance of microbiology in general practice
Letter
Authors: Drake Linda
Published: May 2014

Linda Drake writes to express some concerns about advertising.
Psoriasis management in primary care
Authors: Page Barbara
Published: May 2014

Living with psoriasis can be arduous, and patients need a correct diagnosis and informed advice and support. Barbara Page explains how practice nurses can help
Addressing acne
Authors: Stevens Deborah
Published: May 2014

Acne is a common skin condition in teenagers, which can cause considerable distress and social isolation, but which is none the less often regarded by sufferers as a right of passage. Treatment of acne should begin early to prevent scarring (Joint Formulary Committee, 2007), which can be permanent in the case of larger lesions (Macleod and Munro, 1986). Although initial improvement is often slow, advice about this and encouragement to start and to continue treatment can have satisfactory outcomes.
Providing a foundation for practice nursing
Authors: Ruscoe Dorf , Farbus Lou
Published: May 2014

Dorf Ruscoe and Lou Farbus provide an overview of a competency-based programme that supports the professional development of nurses new to general practice, and highlight some of the key factors that underpin its success
Urinary tract infections in children
Authors: Watkins Jean
Published: May 2014

Six-month old George was a sickly baby. His mother was concerned that he was irritable, off his feeds, and vomiting at times. She took him to the surgery when he developed a fever and became even more ill. Apart from a raised temperature, the doctor could find no specific signs to explain his illness. He was admitted to hospital for further investigation and found to have a urinary infection, which was treated with an antibiotic. A renal ultrasound was performed to exclude any underlying causes.
Protecting yourself from abusive patients
Authors: Hampton Richard
Published: May 2014

Nurses often have to deal with difficult and sometimes aggressive patients. Richard Hampton explores the issues and offers some advice when faced with abuse
Cutaneous T-cell lymphoma
Authors: Watkins Jean
Published: May 2014

Cutaneous T-cell lymphomas (CTCLs) are uncommon conditions that rarely present in the surgery. The fact that nurses are unlikely to have experienced such a problem previously may make it diffi cult to recognize the signifi cance of symptoms that should be taken seriously, and therefore delay a correct diagnosis. This article will mainly focus on mycosis fungoides, which is the most common type of CTCL. Symptoms of this low-grade lymphoma often respond to treatment, but in the long run, it is incurable and a fatal outcome may follow. Studies have shown that the prognosis and mortality are related to the stage at which the condition is diagnosed (Pinter-Brown, 2006). It is, therefore, important to be aware of the warning signs that could enable an early diagnosis and early intervention, and benefit the patient.
Scarlet fever: The elusive illness
Authors: Duncan Debbie
Published: May 2014

Although the incidence of scarlet fever is less prevalent than it once was, it is still important for practice nurses to be aware of the symptoms, treatments and complications. Debbie Duncan discusses the childhood illness
Whiplash
Authors: Stevens Deborah
Published: May 2014

Whiplash is the commonly used term for post-traumatic neck injury. The usual cause is a road traffic ‘shunt’, when the victim is seated in a slow moving or stationary car, which is hit by another vehicle from behind and causes an extension/flexion injury to the neck. As traffic congestion increases, whiplash is routinely encountered in primary care, with the more serious cases being seen on a daily basis in accident and emergency departments. The symptoms of whiplash tend to be delayed, with neck pain and stiffness typically starting some 6–12 hours after the accident (Walsh et al, 1999). Assessment should include excluding any ‘red flags’ indicating serious spinal injury (Table 1), and treatment consists of pain relief and gentle mobilization of the neck. Reassurance should be given that the delayed onset of symptoms is normal, and that these may take a number of weeks to heal completely.
Primary angioplasty for myocardial infarction
Authors: Neal Julia
Published: May 2014

Effective follow-up in primary care is needed by the growing number of people having angioplasty for a myocardial infarction. Julia Neal explains the procedure and looks at the support patients need
An introduction to pharmacodynamics
Authors: Thomas Arwel , Young Simon
Published: May 2014

Arwel Thomas and Simon Young introduce the key principles of pharmacology and explain some of the important ways in which drugs act on the body
Recognizing and treating Bornholm disease
Authors: Duncan Debbie
Published: May 2014

Bornholm disease (or ‘devil's grip’) is a rare but highly contagious viral infection that begins with sudden, severe and intermittent pleuritic pain. Debbie Duncan explains what practice nurses need to know
Access to urgent care: Looking to the future
Authors: Martin Jeannett
Published: May 2014

Important changes are taking place in the provision of out-of-hours and urgent care. Jeannett Martin reports on discussions at a recent conference on urgent care
Understanding narcolepsy, part 2: Accurate diagnosis and effective management
Authors: Cook Neal F
Published: May 2014

The complexity of narcolepsy is a challenge to patients and health professionals who wish to achieve optimal management of this condition. This complexity is often associated with the reduced health-related quality of life experienced by those with narcolepsy. The first article in this two-part series considered the definition of narcolepsy and discussed its neuropathophysiology (Cook, 2008). This second article focuses on the diagnosis and management of narcolepsy, essential components of care requiring a multiprofessional approach to maximize patient outcomes, coping and health-related quality of life.
Give a little to save a lot
Authors: Low Eric
Published: May 2014

It is often touted as a truism that the NHS needs to ration resources, that not all treatments can be funded. Indeed, as a Myeloma UK survey of 103 myeloma specialists (2008) showed, three quarters of doctors treating myeloma have had their applications for a preferred treatment option rejected by primary care trusts with cost cited as the main reason for the knock back.
Ruth Thomas: A Queen';s Nurse
Authors: Thomas Ruth
Published: May 2014

Ruth Thomas won the Queen's Nurse title after 10 years of work with the Army. She talked to Lucy Jolin about the joys of her job.
Deborah Stevens: Still learning
Authors: Stevens Deborah
Published: May 2014

Deborah Stevens talks to Lucy Jolin about why it is never to late to move forward in your career
The psychological effects of acne in teenagers
Authors: Joseph Diane , Sterling Anne
Published: May 2014

Diane Joseph and Anne Sterling discuss the importance of understanding the psychological effects that acne can have on adolescents
A practical guide to chronic heart failure
Authors: Crosbie Carol , Coppinger Teresa , Waywell Carolyn
Published: May 2014

Carol Crosbie, Teresa Coppinger and Carolyn Waywell discuss how to recognize the signs of chronic heart failure and explain the available interventions
Paracetamol prophylaxis: what the evidence says
Authors: Prosad Paul Siba , Whibley Jennifer
Published: May 2014

Siba Prosad Paul and Jennifer Whibley look at why paracetamol should not be routinely given at the time of childhood vaccinations
Fiona's blog
Authors: Peniston-Bird Fiona
Published: May 2014

Supplementary prescribing was introduced in 2003 before nurses were able to prescribe from the whole BNF. It is a different model of prescribing from independent prescribing. When undertaking the V300 prescribing training, supplementary prescribing is a mandatory part of the course so the result is dual qualification and registration.
The meaning of quality of life: A Lifepsychol survey
Authors: Bindemann Neil
Published: May 2014

Neil Bindemann outlines the results of a new online survey to explore the issue of ‘quality of life’ and to find out what it means to people living with a long-term illness
Hypoglycaemia in type 2 diabetes
Authors: MacArthur Clare
Published: May 2014

Hypoglycaemia is common, troublesome and hazardous for people with diabetes. Clare MacArthur argues that it needs to be seen as a side effect of treatment, rather than something to be expected as part of living with diabetes.
Recording an accurate ECG
Authors: Jevon Phil
Published: May 2014

An ECG is an essential diagnostic tool often undertaken in general practice for patients with coronary heart disease. Phil Jevon outlines the basic principles for achieving an accurate recording
The effect of weight on mental health
Authors: Mulrooney Hilda
Published: May 2014

Being overweight or obese increases the risk of many physical conditions. However, weight may also have an effect on mental health. Hilda Mulrooney discusses the evidence for this possibility and how health professionals can assist
The increased risk of diabetes in people with severe mental illness
Authors: Hardy Sheila
Published: May 2014

People with severe mental illness have worse physical health compared to the general population, and a greater risk of developing diabetes. Sheila Hardy highlights the need for better screening and support
The health threat of antibiotic resistance
Authors: Haddock Gail
Published: May 2014

Good antibiotic stewardship is an international health priority. Gail Haddock explains why action must be taken now to ensure responsible antibiotic prescribing
Assessing menorrhagia and its treatment
Authors: Perry Margaret
Published: May 2014

Menorrhagia is a distressing condition with the potential to bring disruption to women's lives on a monthly basis. Margaret Perry gives an insight into the assessment and diagnosis of the condition
Factors to consider when offering pre-travel ski advice
Authors: Townend Mike
Published: May 2014

Many people go on winter sports holidays every year without seeking pre-travel advice. Mike Townend outlines the benefits of being prepared, and useful information for practice nurses to use at a pre-travel consultation.
Managing simple lower UTI in women under 65
Authors: Haddock Gail , MacDonald Alison
Published: May 2014

Urinary tract infection in women under 65 years appears commonly in general practice. Gail Haddock and Alison MacDonald explain how appropriate management of simple UTIs helps preserve the precious resource of antibiotics
Group therapy: a natural opportunity for support
Authors: Williams Briony
Published: May 2014

Briony Williams looks at the benefits of initiating group therapy in primary care to provide peer support to people with anxiety disorders
Treasure baskets
Authors: Jackson Caroline , Miller Collette
Published: May 2014

Treasure baskets are a successful way to offer babies and young children an activity of discovery and investigation
Words you need to know: Emotional intelligence
Authors: Bayley Ros
Published: May 2014

This is the first in a series of articles which set out to explain educational buzz words or jargon in a straightforward way. Ros Bayley starts with a look at emotional intelligence – what it means, where the idea comes from and why you need to know about it
Giving children medicine
Authors: Pritchard Tricia
Published: May 2014

Many carers have children who need to take medication at some time. Some children need regular treatment for a medical condition. You want to do the best for children, but you will also be concerned about your responsibilities and liability if things go wrong. We offer some advice
Eating well: guidance for school aged children
Authors: Packman Julia
Published: May 2014

Good nutrition is important for everyone. However, healthy eating is especially important for children as they are growing rapidly. They need all the energy and nutrients they can get and require a lot more for their body size than adults do
Responding to the world in a creative way
Authors: Lindon Jennie
Published: May 2014

How creative can babies be if they are given the freedom to explore? Whether it’s playing with paint, exploring with dough or singing a song, it is always the process and not the product that matters
My first hand and footprints
Authors: Jackson Caroline , Miller Collette
Published: May 2014

This is a lovely activity that children can take part in whatever their age or stage of development. Plan it for occasions such as Mother’s/Father’s Day, birthdays or festivals such as Christmas and Diwali
Managing mealtimes
Authors: Hardcastle Lindy
Published: May 2014

Mealtimes with small children can be a battleground or the highlight of the day. How you manage them is important, from the facilities you provide to the routines you establish. As always, the secret is to plan well and lay down firm boundaries
Scrap heap challenge
Authors: McKay Beck
Published: May 2014

There are fewer opportunities nowadays for children to be creative and develop practical hands-on skills. So give them a pile of junk, some string, glue, masking tape and scissors and challenge their imagination and abilities, says Beck McKay
Make a special area for quiet time
Authors: Jackson Caroline , Miller Collette
Published: May 2014

Some young children spend long periods of the day in child care settings away from their families and home environment, so it is important that they have a quiet time for relaxation and sleep