bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the Communication Effects of Health Campaigns
Authors: Leavy Justine E. , Bauman Adrian E. , Rosenberg Michael , Bull Fiona C.
Published: May 2014

Community-wide health communication campaigns have been used for over 30 years to increase awareness of the benefits of physical activity. The relationship between raising campaign awareness influencing physical activity behavior directly or through intermediate variables has not been fully explored. The aims of this study were to examine the relationship between campaign awareness and four socio-cognitive variables on changes in physical activity levels among a cohort of adults exposed to a physical activity campaign. Find Thirty every day® was a population-wide, serial mass media campaign delivered in Western Australia. There was a significant association between campaign awareness and higher outcome expectations. The likelihood of higher outcome expectations and higher decisional balance was significantly greater in people who maintained campaign awareness compared with people who had no/relapsed campaign awareness. Those with higher compared with lower outcome expectation, self-efficacy, social support, and decisional balance were more likely to remain sufficiently active. A significant proportion of people who remained insufficiently active were not aware of the campaign. Finally, we found an association between the four individual socio-cognitive variables and levels of change in physical activity that appeared to be independent. The article adds to a small but growing body of literature that reinforces the importance of target audience refinement in physical activity mass media campaigns.
“You Have to Have a Certain Feeling for This Work”
Authors: Börjesson Ulrika , Bengtsson Staffan , Cedersund Elisabet
Published: May 2014

Increased care worker knowledge has been emphasized for improving quality of care for older persons in organized elder care in Sweden. However, care workers and national policies are not always corresponding, with observations suggesting that care workers emphasize tacit knowledge. The aim of this article is to explore the nature of this kind of knowledge and how it can be identified and described. Field notes from participant observations at two elder care units in Sweden serve as the empirical material. Knowledge use for staff in elder care is part of a process of knowledge making and knowledge shaping. Analysis of the field notes identified the themes of “feeling for work” and “acting and artistry” as parts of a tacit knowledge in elder care. The processes of knowledge and job execution are closely intertwined, making them difficult to separate or even understand without a deeper insight.
Migraine among medical students in Kuwait University
Authors: Al-Hashel Jasem Y , Ahmed Samar Farouk , Alroughani Raed , Goadsby Peter J
Published: May 2014

Background

Medical students routinely have triggers, notably stress and irregular sleep, which are typically associated with migraine. We hypothesized that they may be at higher risk to manifest migraine. We aimed to determine the prevalence of migraine among medical students in Kuwait University.

Methods

This is cross-sectional, questionnaire-based study. Participants who had two or more headaches in the last 3 months were subjected to two preliminary questions and participants with at least one positive response were asked to perform the validated Identification of Migraine (ID Migraine™) test. Frequency of headache per month and its severity were also reported.

Results

Migraine headache was suggested in 27.9% subjects based on ID-Migraine™. Migraine prevalence (35.5% and 44%, versus 31.1%, 25%, 21.1%, 14.8%, 26.5%, p < 0.000), frequency (5.55 + 1.34 and 7.23 + 1.27, versus 3.77 ± 0.99, 2.88 ± 0.85, 3.07 ± 0.96, 2.75 ± 0.75, 4.06 ± 1.66, p < 0.000); and severity of headache (59.1% and 68.2%, versus 28.3%,8.3%, 6.7%,16.7%, p < 0.000; were significantly increased among students in the last 2 years compared to first five years of their study. Stress 43 (24.9%), irregular sleep 36 (20.8%), and substantial reading tasks 32 (18.5%), were the most common triggering factors cited by the students.

Conclusion

The prevalence of migraine is higher among medical students in Kuwait University compared to other published studies. The migraine prevalence, frequency and headache severity, all increased in the final two years of education.
Migraine without aura is not associated with incomplete circle of Willis: a case–control study using high-resolution magnetic resonance angiography
Authors: Ezzatian-Ahar Shabnam , Amin Faisal Mohammad , Obaid Hayder Ghani , Arngrim Nanna , Hougaard Anders , Larsson Henrik B W , Ashina Messoud
Published: May 2014

Background

The circle of Willis is an important source of collateral blood flow to maintain adequate cerebral perfusion, particularly in the posterior circulation. Some studies report a relationship between incomplete circle of Willis and migraine, whereas other studies show no difference between the prevalence of incomplete circle of Willis in migraineurs and controls. In the present study we compared the prevalence of incomplete circle of Willis in female migraine patients without aura to female healthy non-migraine controls.

Using 3-Tesla magnetic resonance angiography we recorded three-dimensional time-of-flight angiograms in 85 female participants (48 migraine patients without aura [median age 28 years] and 37 healthy controls [median age 25 years]). The images were subsequently analysed blindly by a neuroradiologist to detect incomplete circle of Willis.

Findings

We found no difference between the prevalence of incomplete circle of Willis in patients, 20/47 (43%), and controls, 15/37 (41%), p = 0.252. Post hoc analysis showed a significant relationship between age and prevalence of incomplete circle of Willis, p = 0.003.

Conclusion

We found no relationship between migraine without aura and incomplete circle of Willis.
A rotation-translation invariant molecular descriptor of partial charges and its use in ligand-based virtual screening
Authors: Berenger Francois , Voet Arnout , Lee Xiao Yin , Zhang Kam YJ
Published: May 2014

Background

Measures of similarity for chemical molecules have been developed since the dawn of chemoinformatics. Molecular similarity has been measured by a variety of methods including molecular descriptor based similarity, common molecular fragments, graph matching and 3D methods such as shape matching. Similarity measures are widespread in practice and have proven to be useful in drug discovery. Because of our interest in electrostatics and high throughput ligand-based virtual screening, we sought to exploit the information contained in atomic coordinates and partial charges of a molecule.

Results

A new molecular descriptor based on partial charges is proposed. It uses the autocorrelation function and linear binning to encode all atoms of a molecule into two rotation-translation invariant vectors. Combined with a scoring function, the descriptor allows to rank-order a database of compounds versus a query molecule. The proposed implementation is calledACPC(AutoCorrelation of Partial Charges) and released in open source. Extensive retrospective ligand-based virtual screening experiments were performed and other methods were compared with in order to validate the method and associated protocol.

Conclusions

While it is a simple method, it performed remarkably well in experiments. At an average speed of 1649 molecules per second, it reached an average median area under the curve of 0.81 on 40 different targets; hence validating the proposed protocol and implementation.
Comparison of non-surgical treatment methods for patients with lumbar spinal stenosis: protocol for a randomized controlled trial
Authors: Schneider Michael , Ammendolia Carlo , Murphy Donald , Glick Ronald , Piva Sara , Hile Elizabeth , Tudorascu Dana , Morton Sally C
Published: May 2014

Background

Lumbar spinal stenosis is the most common reason for spinal surgery in older adults. Previous studies have shown that surgery is effective for severe cases of stenosis, but many patients with mild to moderate symptoms are not surgical candidates. These patients and their providers are seeking effective non-surgical treatment methods to manage their symptoms; yet there is a paucity of comparative effectiveness research in this area. This knowledge gap has hindered the development of clinical practice guidelines for non-surgical treatment approaches for lumbar spinal stenosis.

Methods/design

This study is a prospective randomized controlled clinical trial that will be conducted from November 2013 through October 2016. The sample will consist of 180 older adults (>60 years) who have both an anatomic diagnosis of stenosis confirmed by diagnostic imaging, and signs/symptoms consistent with a clinical diagnosis of lumbar spinal stenosis confirmed by clinical examination. Eligible subjects will be randomized into one of three pragmatic treatment groups: 1) usual medical care; 2) individualized manual therapy and rehabilitative exercise; or 3) community-based group exercise. All subjects will be treated for a 6-week course of care. The primary subjective outcome is the Swiss Spinal Stenosis Questionnaire, a self-reported measure of pain/function. The primary objective outcome is the Self-Paced Walking Test, a measure of walking capacity. The secondary objective outcome will be a measurement of physical activity during activities of daily living, using the SenseWear Armband, a portable device to be worn on the upper arm for one week. The primary analysis will use linear mixed models to compare the main effects of each treatment group on the changes in each outcome measure. Secondary analyses will include a responder analysis by group and an exploratory analysis of potential baseline predictors of treatment outcome.

Discussion

Our study should provide evidence that helps to inform patients and providers about the clinical benefits of three non-surgical approaches to the management of lumbar spinal stenosis symptoms.

Trial registration

ClinicalTrials.gov identifier: NCT01943435
Ccdc13; a novel human centriolar satellite protein required for ciliogenesis and genome stability
Authors: Staples Christopher J. , Myers Katie N. , Beveridge Ryan D. D. , Patil Abhijit A. , Howard Anna E. , Barone Giancarlo , Lee Alvin J. X. , Swanton Charles , Howell Michael , Maslen Sarah , Skehel J. Mark , Boulton Simon J. , Collis Spencer J.
Published: May 2014

Here we identify coiled-coil domain-containing protein 13 (Ccdc13) in a genome-wide RNA interference screen for regulators of genome stability. We establish that Ccdc13 is a novel centriolar satellite protein that interacts with PCM1, Cep290 and pericentrin, which prevents the accumulation of DNA damage during mitotic transit. Depletion of Ccdc13 results in loss of microtubule organisation in a manner similar to PCM1 and Cep290 depletion, although Ccdc13 is not required for satellite integrity. We show that microtubule regrowth is enhanced in Ccdc13-depleted cells, but slowed in cells overexpressing Ccdc13. Furthermore, in serum-starved cells, Ccdc13 localises to the basal body, is required for primary cilia formation, and promotes the localisation of the ciliopathy protein BBS4 to both centriolar satellites and cilia. These data highlight the emerging link between DDR factors, centriolar/peri-centriolar satellites and cilia-associated proteins and implicate Ccdc13 as a centriolar satellite protein that functions to promote both genome stability and cilia formation.
Adjustments, extinction, and remains of selenocysteine incorporation machinery in the nematode lineage
Authors: Otero Lucía , Romanelli-Cedrez Laura , Turanov Anton A. , Gladyshev Vadim N. , Miranda-Vizuete Antonio , Salinas Gustavo
Published: May 2014

Selenocysteine (Sec) is encoded by an UGA codon with the help of a SECIS element present in selenoprotein mRNAs. SECIS-binding protein (SBP2/SCBP-2) mediates Sec insertion, but the roles of its domains and the impact of its deficiency on Sec insertion are not fully understood. We used Caenorhabditis elegans to examine SBP2 function since it possesses a single selenoprotein, thioredoxin reductase-1 (TRXR-1). All SBP2 described so far have an RNA-binding domain (RBD) and a Sec-incorporation domain (SID). Surprisingly, C. elegans SBP2 lacks SID and consists only of an RBD. An sbp2 deletion mutant strain ablated Sec incorporation demonstrating SBP2 essentiality for Sec incorporation. Further in silico analyses of nematode genomes revealed conservation of SBP2 lacking SID and maintenance of Sec incorporation linked to TRXR-1. Remarkably, parasitic plant nematodes lost the ability to incorporate Sec, but retained SecP43, a gene associated with Sec incorporation. Interestingly, both selenophosphate synthetase (SPS) genes are absent in plant parasitic nematodes, while only Cys-containing SPS2 is present in Sec-incorporating nematodes. Our results indicate that C. elegans and the nematode lineage provide key insights into Sec incorporation and the evolution of Sec utilization trait, selenoproteomes, selenoproteins, and Sec residues. Finally, our study provides evidence of noncanonical translation initiation in C. elegans, not previously known for this well-established animal model.
Use of health institutions by pregnant women in Zambia
Authors: Ngoma Catherine Mubita , Mbukwa Ruth T.
Published: May 2014

The aim of the study was to investigate factors contributing to under-use of health facilities for deliveries by pregnant women. A sample of 62 respondents was selected using systematic sampling procedures. Data was collected using a semi-structured interview schedule. In addition, two focus group discussions were held with 20 participants who did not participate in the interviews. The findings found that a proportion of pregnant women are delivering at home with the assistance of unskilled attendants. The results also revealed that lack of knowledge about risks of home deliveries, distance to the health facilities, lack of transport, unaffordable fees, poor staff attitude and socio-cultural practices were some of the factors that hindered mothers from utilizing the health institutions for deliveries.
Perception of family violence by selected adolescents in Nigeria
Authors: Ogunfowokan Adesola A , Irinoye Omolola O , Oyeleye Babatunde A
Published: May 2014

Different adolescents view violating behaviour differently, and the dispute in beliefs may shape how they treat their children in the future. School nurses can make a difference in helping adolescents to understand correct behaviour and incorrect behaviour.
Ten steps to successful poster presentation
Authors: Hardicre Jayne , Devitt Patric , Coad Jane
Published: May 2014

Receiving a letter confirming acceptance for you to present a poster at a conference can evoke mixed emotions. Joy, panic, fear and dread are among the many possible emotions and this is not exclusive to first-time presenters. Developing an effective poster presentation is a skill that you can learn and can provide a rewarding way to present your work in a manner less intimidating than oral presentation (Shelledy, 2004). The key to successful poster presentation is meticulous, timely, well informed preparation. This article outlines ten steps to help guide you through the process to maximize your success.
China is forced to improve food safety after baby milk scandal
Authors: Bainbridge Jane
Published: May 2014

A chinese health ministry official called for a new system for food safety supervision after tainted milk powder led to the hospitalization of almost 13 000 children.
Young people's knowledge and experience of contraception services
Authors: Sindawe James , Nzama Bongi
Published: May 2014

Pregnancy among teenagers is a concern worldwide. Several studies have been conducted and the findings reveal limited knowledge related to conception and contraception. As a result teenagers find it difficult to correlate pregnancy to non-use of contraceptives. Teenagers' main sources of information are their peers but also parents and teachers; so teenagers are often exposed to inaccurate information. Midwives and nurses are the main health professionals allocated to the role of educating and supplying contraceptives to women and teenagers, but teenagers experience them as being judgmental while offering this service. Nurses and midwives find it difficult to provide contraceptives to teenagers as they feel it is improper for teenagers to engage in any sexual relationships. For this reason teenagers who experience this attitude of nurses and midwives are staying away from these health services and exposing themselves to pregnancy.
Self-reported pains during hysterosalpingography
Authors: Udoh Benjamin E , Okpala CC , Ohagwu Christopher C
Published: May 2014

The aim of this study was to determine the effect of the site of clipping of the cervix on the degree of pain experienced by the women undergoing hysterosalpingography. One hundred and twenty women who met the inclusion criteria were recruited for the study. Strict sterile procedure for hysterosalpingography was carried out on all women and verbal detector scales were used to assess pain perception. Pearson's correlation analysis was carried out to assess the relationship between sites of clipping of the cervix with the degree of pain reported by the women. Tests were two-tailed with P<0.05 indicating statistical significance. Age correlated negatively but significantly (r=0.32, P=0.02) with pain. This suggests that younger women are more sensitive to pain than older women. None of the sites for clipping of the cervix correlated significantly with the pain experienced by the women.
Kangaroo care in a Mozambican perinatal ward: A clinical case study
Authors: Söderbäck Maja , Erlandsson Kerstin
Published: May 2014

Kangaroo mother care (KMC) was first introduced in Mozambique in 1984. The aim of this study was to describe Mozambican mothers’ experiences of going through admission, passing from an intensive care ward to a nursery ward with their premature baby, undergoing KMC training before early discharge. A clinical case study was conducted, involving naturalistic observations and a face-to-face interview with 41 mothers participating to complete a questionnaire. Descriptive statistics and manifest content analysis were used in this study. The results show that the mothers were of low socio-economic standing and felt that they did not have enough information on KMC. The hierarchical organization within the hospital setting as well as communalistic behaviours influenced the mothers’ support of KMC, including information, communication, relationships and actions. The conclusion is that there is an important challenge for trained neonatal nurses to improve the guidelines for KMC and to empower mothers and their families to adopt KMC.
Follow-up of women until 6 weeks after delivery: Students' experiences
Authors: Modiba L.M.
Published: May 2014

The aim of this study was to explore and describe student midwives’ experiences on the follow-up of a woman from pregnancy, birth and post-partum until 6 weeks after delivery. The research design was qualitative, descriptive, exploratory and contextual. A purposive sampling was used and 21 student midwives who enrolled for midwifery consented to be part of the study. Semi-structured face-to-face interviews were conducted with the student midwives after completing this project. These interviews were tape recorded and transcribed verbatim by an independent transcribing service. The findings in relation to the research question were synthesized under three themes: building relationships with the follow-up women; challenges associated with the follow-up experience; and positive aspects of this experience. Conclusion: The follow-up experience provided midwifery students with unique and important learning opportunities that they would not experience in standard or hospital-based clinical placements alone.
Determinants of postnatal care uptake in Bikita district, Zimbabwe
Authors: Pomerai K.W. , Shambira G. , Mudyiradima R.F.
Published: May 2014

Introduction:

The postnatal period is a good opportunity to detect medical problems of the mother and neonate and reduce morbidity and mortality. This study was conducted to determine factors associated with low postnatal care uptake in Bikita.

Methods:

A 1:1 unmatched case-control study was conducted. Random sampling was used to select cases and controls from antenatal care and postnatal care registers at health centres. An interviewer-administered questionnaire using constructs of the Health Belief Model was used. A focus group discussion was conducted with women who had come for antenatal and postnatal care.

Results:

A total of 150 cases and 150 controls were recruited. Independent factors associated with non-uptake of postnatal care uptake were: practising seclusion until umbilical cord fell off (adjusted odds ratio (AOR) 3.43; 95% confidence interval (CI): 1.73–6.81); residing in village/resettlement (AOR 3.71; 95% CI: 1.30–9.90); delivering at home (AOR 6.0; 95% CI: 3.50–12.71); and staying more than 5 km from health centre (AOR 1.73; 95% CI: 1.03–2.89). Factors associated with postnatal care uptake were secondary/tertiary level of education (AOR 0.25; 95% CI: 0.11–0.73) and ability of mother to attend postnatal care within 48 hours after at-home delivery (AOR 0.60; 95% CI: 0.21–0.96).

Discussion and Conclusion:

Factors associated with reduced likelihood of the 10-day postnatal care uptake in Bikita district were: practising seclusion until umbilical cord fell off; residing in a village or resettlement; delivering at home; and living more than 5 km from the nearest health centre. Outreach services have been launched for postnatal care and to ensure that village health workers are trained in basic postnatal care.
Women's health beliefs and breast cancer screening practices in Nigeria
Authors: Olowokere Adekemi , Onibokun Adenike , Irinoye Omolola
Published: May 2014

Receiving a diagnosis of breast cancer and coping with subsequent treatments can be highly threatening experiences that may influence women's breast screening practices. It is therefore important to have a good understanding of women's beliefs and behaviour where breast cancer may be concerned. This study examined the influence of women's beliefs on breast screening practices (BSE) in four rural communities of Nigeria. Utilizing cross-sectional design, women's beliefs were measured using the Health Belief Model (HBM) scale adapted to Nigerian cultural settings. Women's perceived risk to breast cancer was found to be moderately high. Self-confidence and intention to participate in health-promoting behaviours were the significant variables that influenced the women's practice of BSE (P = 0.000 and P = 0.021 respectively). The authors therefore recommend that community health nurses should promote activities geared towards mastery of BSE by promoting self-confidence in women through regular demonstration and reinforcement of health educational sessions at the primary health care level.
Evaluation of haemoglobin levels in pregnant women in Zimbabwe
Authors: Mwanza Estele , Masamha Blessing , Kuchenga Moud Margret , Mufisha Micho
Published: May 2014

A cross-sectional study was carried out to evaluate the haemoglobin (Hb) levels during pregnancy in Bindura District of Zimbabwe. The main objective was to establish the effect of varying age and parity on Hb levels in pregnant women. Blood samples were taken from 60 pregnant women visiting Shashi Private Hospital for antenatal care for 2 weeks. The ages, parity and physical addresses of the participants were recorded. The highest mean Hb level recorded was 11.350 g/dL in the 35–39 years category and 11.337g/dL for the para 0 gravida 4. There were no significant differences in the mean Hb levels across the different age groups and the parity groups. However, the mean Hb levels were generally low. Hb levels need to be checked and rectified at the early stages of pregnancy to attain the required Hb level throughout pregnancy through improved diet and iron supplementation.
How Option B+ is shifting the PMTCT paradigm
Authors: Adler Michelle R , Riley Patricia L , Bandazi Sheila , Davis Margarett K
Published: May 2014

Affordable and effective interventions have been identified that can prevent new infant HIV infections, maintain the health of mothers, and greatly reduce transmission between discordant partners. Yet, 330 000 HIV-infected infants were born in 2011 worldwide, in part due to operational challenges inherent in the design of current PMTCT programmes. Option B+, the provision of life-long antiretroviral treatment (ART) to all pregnant and breastfeeding women, was recently introduced as a progressive and innovative approach to simplify service delivery and improve maternal and infant outcomes. This emphasis on treatment as the cornerstone of PMTCT has catalysed a shift in thinking about the PMTCT paradigm. No longer can PMTCT viewed as a time-limited intervention around pregnancy and breastfeeding. It must be reconceived as multiple overlapping continua of care that address the health and family planning needs of HIV-positive women throughout their reproductive years. Optimising maternal ART and exposed infant follow-up will require a bridging of maternal, neonatal, and child health programmes with HIV treatment programmes to support alternative service delivery models, develop new health care worker competencies, and address infrastructural constraints. The engagement of nurses and midwives in this PMTCT transformation will be critical to meeting the global goal of an AIDS-free generation.
An introduction to temporary pacing
Authors: McNaughton Amanda
Published: May 2014

This article is intended to give an insight into temporary pacing, the indications for pacing, the types of pacing most commonly used and some of the key issues surrounding this intervention.
Treating a patient with a supraventricular tachycardia
Authors: Hamilton Rozi
Published: May 2014

This article presents the case management of a client admitted to the coronary care unit for investigations into palpitations. She had been brought into the accident and emergency department with a supraventricular tachycardia that had self-terminated in the ambulance en route to the hospital. Personal details have been changed to protect patient confidentiality.
Becoming a cardiac service improvement facilitator
Authors: Nelson Sara
Published: May 2014

Sara Nelson describes the winding road that eventually led to her present role as a cardiac service improvement facilitator.
Health care: Another perspective
Authors: Johnson Kate
Published: May 2014

For most of 2006 I have been looking at cardiac care from a different perspective, that of a concerned relative. When any of us become users of health care, either for ourselves or for those close to us, it is inevitable that we will look at our working world with different eyes. On the whole, having an understanding of how the system works, the terminology used (even if the specialty is unfamiliar) and the professionals we are likely to encounter can be beneficial. It also can help us empathize with our patients’ and their relatives’ needs as well as highlight the inevitable frustrations that can develop in health care. For me the greatest frustration has been around information giving. While I may know what standards, pathways and guidelines may exist in cardiac care, this of course doesn't always mean that they will be followed.
Obesity: The Cinderella risk factor for coronary heart disease
Authors: Haslam David
Published: May 2014

Not enough emphasis has been placed on conquering obesity. David Haslam explains how important it is as a risk factor for cardiovascular disease and discusses how it can be tackled.
ECG of the month
Authors: Whitbread Mark
Published: May 2014

Mark Whitbread presents an ECG for you to analyse. The answer and management plan are on page 595
Cardiac tamponade in the postoperative period following coronary artery bypass grafts
Authors: Thorn Michelle
Published: May 2014

This article discusses the care of a patient following coronary artery bypass grafting surgery. The patient developed a cardiac tamponade during the immediate postoperative phase. The patient was a 70-year-old gentleman who did not have any previous medical conditions and who was diagnosed with angina. He was admitted to the overnight intensive recovery unit following surgery. The care and management of this patient is discussed together with the clinical manifestations and treatment of cardiac tamponade.
Antiplatelet therapy in the treatment and prevention of thrombus formation
Authors: Walthall Helen
Published: May 2014

It is established practice to administer antiplatelet drugs to patients with known CHD (Department of Health, 2000). This pharmacological prevention is based on the findings of a number of randomized controlled trials that have set out to establish a drug of choice and the dose required to reduce the risk of thrombosis formation. The following paper will review the role of platelets in maintaining haemostasis and in cardiovascular disease. It will then discuss how antiplatelet drugs can inhibit the function of platelets and so reduce the risk of thrombosis formation. The pharmacology of aspirin and clopidogrel will be reviewed and the evidence base presented for their use.
Becoming a cardiac surgical nurse case manager
Authors: Brampton Heather
Published: May 2014

Heather Brampton describes the history and future of nurse case management and the effect this has on her role in patient care
Should the NHS be profitable?
Authors: Cosgrave Rebecca
Published: May 2014

It has been a tough few weeks for the National Health Service. In the run-up to the Budget and the end of the financial year a number of hospitals have announced cuts in jobs. The latest cuts to be announced were at the Royal Free Hampstead NHS Trust where 480 people are going to lose their positions. It isn’t yet clear what types of jobs these might be but it is extremely concerning, particularly when Gordon Brown did not announce any further investment in the NHS except for a minimal increase in nurses’ wages.
Technology is detrimental to basic nursing assessment
Authors: Rawlings-Anderson Karen
Published: May 2014

Karen Rawlings-Anderson advocates a hands-on approach to patient assessment and stresses that technology should complement rather than replace such skills.
ECG of the month: 2
Authors: Whitbread Mark
Published: May 2014

Mark Whitbread presents an ECG for you to analyse. The answer and management plan will be published next month
Central venous pressure monitoring: A practical guide
Authors: Naughton Corina
Published: May 2014

Corina Naughton discusses the principles and management of central venous pressure monitoring.
Read this and write for us
Authors: Johnson Kate
Published: May 2014

Seeing your work in print for the first time is an achievement to feel justifiably proud of. The process of writing a paper for publication can seem very time consuming and many nurses can be put off by the thought of potential rejection.
How nurses can influence health care policy
Authors: Barnett Maree
Published: May 2014

Maree Barnett tells us how her experience led to her present role with the Department of Health and discusses the challenges which face many nurses today.
Postoperative physiotherapy: Myths and realities
Authors: Tham Gemma
Published: May 2014

The physiotherapeutic management of patients after cardiac surgery is constantly evolving. The traditional practice of treating all patients daily with routine breathing exercises has been regularly challenged and shown to confer no benefit in the uncomplicated case. This article will briefly outline the common postoperative pulmonary changes which occur after cardiac surgery and describe the physiotherapy intervention used for this patient group. This should clarify the practice changes which should be occurring in cardiac surgery units. These changes will have an impact on nursing management since physiotherapists often rely on nurses to continue some of the treatments prescribed during the day. For simplicity, this article will not include the management of those patients who require prolonged mechanical ventilation or those who suffer significant neurological insult.
ECG of the month: 3
Authors: Whitbread Mark
Published: May 2014

Mark Whitbread presents an ECG for you to analyse. The answer and management plan will be published next month
Managing chronic disease
Authors: Margereson Carl
Published: May 2014

This excellent book will be an important resource for specialist nurses involved in secondary prevention. The scene is set by exploring relevant pathophysiology and epidemiology. Symptom control is crucial when caring for patients with on going cardiac problems and to do this a sound understanding of the underpinning pathophysiology is essential. Readers will therefore find this a good introductory section.
How should we express ourselves?
Authors: Cosgrave Rebecca
Published: May 2014

It was great to meet some of you at the British Cardiac Society/British Association for Nursing in Cardiac Care (BANCC) conference in Glasgow last month. It was really interesting to get some direct feedback about the journal and put some faces to names. I also hope Kate and I managed to persuade some of you that you want to put pen to paper!
The heart of cardiovascular nursing is beating loudly and is being heard
Authors: Jones Ian
Published: May 2014

Ian Jones discusses how the British Association for Nursing in Cardiac Care can suppor t nurses who work with patients with cardiovascular disease.
Giving psychological support to patients with implantable cardioverter defibrillators
Authors: Ross Joanna
Published: May 2014

Joanna Ross gives a personal account of her experience as someone who needed an ICD and discusses the psychological support people need when in this situation.
The nursing route to becoming a resuscitation officer
Authors: Boyd Maureen
Published: May 2014

Maureen Boyd discusses the importance of resuscitation officers and how nurses need to develop the skills to treat critically ill patients before they experience an cardiopulmonary arrest.
Primary prevention for CHD: Past evidence, present measures and future challenges
Authors: Wrigley Martha , Pakrashi Tapesh , MaslinProthero Sian , Watkinson Graham
Published: May 2014

This paper discusses the importance of primary prevention in reducing coronary heart disease. The first part reviews UK studies on primary prevention in coronary heart disease (and also looks briefly at the Euro-Action study) and illustrates how past studies have influenced our current approach. The second part considers the government's current policy on CHD prevention and suggests that the future focus for preventative care should be at a more individual level.
Ventricular assist devices: An overview
Authors: O'Donovan Kate
Published: May 2014

This article provides an overview of ventricular assist devices. It addresses how a ventricular assist device works, its indications, which patients are most suitable and the nursing and health implications for the provision of care before and after the device has been implanted. Although the care after implantation is similar to postoperative care for a person with heart failure, there is an added dimension in caring for patients with this device. A major component of this is addressing the patients’ and families’ psychosocial concerns and the prevention of infection.
ECG of the month
Authors: Whitbread Mark
Published: May 2014

Mark Whitbread presents an ECG for you to analyse. The answer and management plan are on page 16
An introduction to cardiac care
Authors: Vythilingum Ramoo
Published: May 2014

Coronary heart disease(CHD) remains a major cause of mortality in the western world and Britain maintains a high position on the league table among leading industrialized countries. Although mortality from CHD has declined since the 1970s it remains a major killer, with around 105 000 deaths each year in the UK. In addition, 230 000 people are having a heart attack annually. Cardiac Care: An Introductory Text offers readers an introduction to cardiac nursing. It starts, as most books on cardiology do, with a brief introduction to the anatomy and physiology of the cardiovascular system, which is combined with a discussion on pathophysiology. This gives the reader an insight into the mechanics of the heart, particularly useful for beginners in this subject. It is refreshing to see a chapter on prevention, albeit on primary prevention. The chapter addresses the issue of CHD from a national perspective, exploring policies which have been implemented. It also critically examines studies on strategies to reduce the incidence of CHD.
Stranger than fiction? Psychosocial risk factors for myocardial ischaemia
Authors: Jones Chris
Published: May 2014

Heart disease is frequently described as being multifactorial in origin. There is a wide body of literature which is concerned with the possible emotional origins of heart disease and, among the many causes of cardiac disease,1 the psychosocial elements are some of the most controversial. This article aims to explore some of the more unusual psychosocial explanations that have been given for heart disease and to examine some of the evidence that is offered in support these explanations.
Do insulin secretagogues remain essential in managing type 2 diabetes?
Authors: Gostling Charles
Published: May 2014

A strong case has been made for the use of the insulin-sensitizing agents, metformin and the thiazolidinediones (also known as glitazones) in the management of type 2 diabetes. Not only do they improve glycaemic control, but they may also reduce the risk of cardiovascular disease. Oral drugs promoting insulin secretion from the β-cells in the pancreas (insulin secretagogues), and in particular the sulphonylureas, have acquired an unfashionable status although they are cost effective and, in general, are well tolerated and safe. There is strong evidence for the benefits of sulphonylurea drugs in reducing the risk of microvascular disease in type 2 diabetes (in particular retinal and renal disease). Additionally, improved glycaemic control using these agents may reduce the risk for myocardial infarction.

Current guidance for the management of type 2 diabetes suggests a stepped approach using lifestyle interventions, insulin-sensitizing agents and insulin secretagogues before progressing to insulin therapy if treatment targets are not achieved using maximally tolerated oral hypoglycaemic therapy. This article considers the role of insulin secretagogues, and in particular sulphonylureas, in managing type 2 diabetes. Attention is given to their relative strengths and weaknesses, as well as to how they might be used in combination with other agents.
Tracing a career path from patient-facing to academic roles
Authors: Jones Ian
Published: May 2014

Ian Jones describes his career journey from staff nurse to manager to lecturer, and shares his thoughts on the importance of staff education and development
Care for cardiac interventions
Authors: O’Donovan Kate
Published: May 2014

Despite the variety of cardiovascular nursing texts available there are only a limited number of texts that address the nursing implications of caring for a person undergoing cardiac intervention. This text is written by a nurse for nurses and addresses the current issues that are encountered when persons undergo cardiac intervention. The author must be complimented for providing a text for this area of cardiovascular nursing.
Does ‘smoke-free’ really make a difference to coronary health?
Authors: Dockrell Martin , Millwardis Debbie
Published: May 2014

Martin Dockrell and Debbie Millward ask: How strong is the evidence that smoke-free laws improve coronary health? And what lessons might there be for patient care?
Mending broken hearts: Acute stress cardiomyopathy
Authors: Kelly Jacinta
Published: May 2014

It has long since been suggested that people can suffer a ‘broken heart’ as a result of severe emotional upset. However, the phenomenon of ‘broken heart’ has only recently been subjected to rigorous scientific enquiry where it now formally recognized as acute stress cardiomyopathy. Acute stress cardiomyopathy, a distinct form of acute dilated cardiomyopathy, results in abrupt left ventricular dysfunction which can be acutely damaging and potentially fatal. However, the old adage ‘time mends a broken heart’ rings true with this condition as prognosis is very favorable with a period of time and appropriate nursing and medical care.
Primary PCI and the role of the ‘thrombolysis nurse’: Threat or opportunity?
Authors: Gamon Roger , Jones Ian , Whitmore Joanne , Charnley Louise , Coleman Luke
Published: May 2014

While particular titles and job roles vary, acute cardiac nurses or ‘thrombolysis nurses’ have been highly influential in ensuring patients with ST-segment elevation myocardial infarction receive thrombolysis therapy with the minimum delay. If primary percutaneous coronary intedrvention (PCI) replaces thrombolysis as the chief reperfusion treatment in the UK in future—which seems likely—then this will inevitably have implications for those nurses for whom thrombolysis activity is a key responsibility. This paper explores some of these issues and discusses potential opportunities related to this change in reperfusion services.
The experts’ guide to chest pain
Authors: Rawlings-Anderson Karen
Published: May 2014

This book is a recent addition to those available for health practitioners involved in the assessment, diagnosis and management of patients who present with chest pain. Written by experts who are both academically and clinically credible, the text guides the reader from general principles of assessment in the first section through to management of patients presenting with specific conditions in which chest pain is a key feature in the second section.
Apheresis of low-density lipoprotein: Treating familial hypercholesterolaemia
Authors: Pottle Alison
Published: May 2014

Heterozygous familial hypercholesterolaemia is the most common genetic disorder in Europe and the USA, affecting about 1:500 of the population. Most patients can control their cholesterol level with a combination of diet and medication. However, for a small number, this is not adequate and they require apheresis of low density lipoprotein ( LDL-apheresis). This care study focuses on the management of a 56-year-old lady with familial hypercholesterolaemia. Her management before the treatment will be discussed, together with details of her LDL-apheresis treatment. Patients with familial hypercholesterolaemia are at an increased risk of developing coronary artery disease and the importance of identifying these patients and ensuring they receive optimum treatment will be presented
ECG of the month
Authors: Whitbread Mark
Published: May 2014

Mark Whitbread presents an ECG for you to analyse. The answer and management plan are on page 149
Front-of-pack nutritional information: The only way
Authors: Hignett Rosemary
Published: May 2014

There has been alot of discussion recently about which is the best way of labelling the nutritional content of food. Rosemary Hignett argues that the traffic light system is the most effective.
Managing insulin resistance with oral hypoglycaemic agents
Authors: Hill Jill
Published: May 2014

Type 2 diabetes is an increasingly common condition, characterized by insulin resistance, which may have been present for many years before diagnosis. The beta cells compensate for the reduced effectiveness of insulin by increasing the production of insulin (hyperinsulaemia), but eventually these compensatory mechanisms begin to fail. Although glycaemic control may initially be achieved with lifestyle modifications which improve insulin sensitivity, eventually oral hypoglycaemic agents and/or insulin are required to maintain normoglycaemia. The use of the appropriate agent to address the underlying stage of diabetes is important. This may also influence the progression of the condition, as well as reduce the risk of cardiovascular disease.
Extent of heart failure self-care as an endpoint to patient education: A literature review
Authors: Cameron Jan , Worrall-Carteris Linda , Driscoll Andrea , New Gishel , Stewart Simon
Published: May 2014

Background: In western countries the number of chronic heart failure (CHF) management programs has escalated in recent times. One key component of them is to teach self-care behaviours that enable affected individuals to monitor themselves and engage in lifestyles that improve their health status.

Aim: The aim of this article is to describe CHF self-care management and to review the literature which examines the effectiveness of patient education on patients’ performance of self-care behaviours.

Design/method: Bibliographical databases were searched for papers published in English between 1982 to 2006. The search used the key words: heart failure, education, self-care and measures. Only randomized controlled trials (RCTs) were selected.

Results: Ten randomized controlled trials were selected that used education as an inter vention and, in total, 1064 patients with CHF participated in these studies. The studies were heterogenous as to the sample population, the health outcomes measured, the education interventions, the expertise of the educator, and the length of time that was spent on teaching patients. No consistent patterns of implementation and specific evaluation of its impact were found, although three respective groups of investigators reported significant differences in recurrent hospitalisation rates and mortality rates which were relative to usual care.

Conclusions: Teaching patients appropriate CHF self-care behaviours can significantly improve their health outcomes. Improvements in self-care were demonstrated in seven studies but only three had used validated instruments to measure such changes. This suggests that no firm conclusions can be drawn about changes in self-care practices.
Conducting an exercise tolerance test
Authors: Tough Jackie
Published: May 2014

Exercise tolerance testing is used to determine whether or not a patient’s chest pain is caused by cardiovascular disease. Jackie Tough describes the principles behind the procedure and how to use it to make a diagnosis.
Come and tell us what you’re doing
Authors: Jones Ian
Published: May 2014

Under the guidance of Kate Johnson the BJCN has established itself as the leading UK cardiac nursing journal. I was therefore delighted to be offered a role as one of the new consultant editors of this journal.
Increasing awareness about arrhythmias
Authors: Lobban Trudie
Published: May 2014

Arrhythmia Awareness Week gives health professionals the opportunity to influence and improve the care of people with heart rhythm disorders. Trudie Lobban tells us how we can take part.
Working in the cardiac catheterization laboratory
Authors: Dixon Kate
Published: May 2014

After working in a medical admissions unit and various surgical areas, Kate Dixon found that the multi-dimensional role of the cardiac catheterization laboratory nurse appealed. She tells us all about it.
Research Round-Up
Authors: Astin Felicity
Published: May 2014

Although resting 12-lead electrocardiogram (ECG) abnormalities are associated with coronary heart disease (CHD), little is known about the prognostic significance of such abnormalities.
‘Ahhh’: A breath of fresh air
Authors: Cosgrave Rebecca
Published: May 2014

I am sure I’m not the only one who is relishing the English smoking ban that came into force this week. From now on there is to be no smoking in virtually all enclosed public spaces, and there will be a fixed penalty for those who fail to comply (Smokefree, 2007).