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7th January 2009 @ 3:56am |
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Volume 3, Number 1, December 2008EDITORIALEditorial We are about to hit the festive season, but it is also a time when many people reflect on the past year and make plans for the next – including thinking about giving up smoking. In this issue we reflect on the impact of the smoking ban in the UK. Hilary Wareing and Nina Gotz from the Tobacco Control Collaborating Centre show how there have been significant benefits in terms of air quality and increased numbers of quitters since the smokefree legislation came into force between March 2006 and July 2007. This has been a significant step forward in improving public health, and provides a foundation to encourage more of your patients to quit. POPULAR There are just not enough hours in the day to read all the research journals, even if you wanted to. This section of BJPCN – Evidence in Practice – will keep you on top of relevant research without having to spend hours in the library. Each review gives you a bite-size summary of new research, pulling out key points for primary care and recommending the action that you might consider taking. NEWSNews from Education for Health POPULAR NEWSNews from the General Practice Airways Group (GPIAG) POPULAR Bronchiectasis is characterised by abnormal, permanent distortion and dilation of one or more of the medium-sized bronchi (>2 mm). It occurs most commonly as a consequence of infection or inflammation. Although relatively uncommon, bronchiectasis is an important and probably under-diagnosed condition and it often coexists with COPD. Accurate diagnosis and appropriate management are needed to reduce the symptoms that patients experience. Primary care professionals need to be alert to the signs and symptoms of bronchiectasis to ensure quick referral to specialist services. POPULAR As mentioned in the last issue (BJPCN Sept 2008), anxiety is a significant and distressing problem for patients with respiratory disease. Anxiety is more common in respiratory disease than in cancer, heart failure or other chronic medical conditions (Kvaal et al 2001). The previous article gave a background to anxiety and highlighted that practice nurses are in an ideal position to screen for anxiety and to provide appropriate support and basic treatment. This article focuses on the management of anxiety using cognitive behavioural therapy skills and techniques. POPULAR PREVENTION IN PRACTICEHas The UK Smoking Legislation Improved Our Health? Between March 2006 and July 2007 smokefree legislation was introduced in Scotland, Wales, Northern Ireland and England, making virtually all enclosed public places and workplaces smokefree. Building on the experience of several other countries, the laws and regulations were designed to protect the health of workers and others from the negative consequences of breathing secondhand tobacco smoke. This article examines the impact that the legislation has had so far and provides guidelines for encouraging patients to stop smoking. PHARMACY MATTERSCommunity Pharmacists: Part of the Healthcare Team The image of community pharmacy and the role of the community pharmacist have changed substantially over the past 5-10 years. Things are set to keep changing with the newly published White Paper for pharmacy in England and the continued restructuring of the health service in Scotland. The community pharmacist’s role will become much more integrated into the multi-professional care of patients. THERAPEUTICS REVEWHow to Manage Sleep Apnoea in Primary Care
The NICE Technology Appraisal of continuous positive airway pressure (CPAP) published in March 2008 has led to dramatically increased referrals for sleep apnoea in most areas. Together with the National ‘Referral to Treatment’ (RTT) 18-week target, there is mounting pressure on Primary Care Trusts to identify patients with obstructive sleep apnoea (OSA). This article describes how OSA can be identified and diagnosed, and how CPAP can be managed in primary care. DID YOU KNOW?Is Immunotherapy an Option for my Patients with Severe Seasonal Allergic Rhinitis? Severe seasonal allergic rhinitis (hayfever) has a significant impact on sufferers’ quality of life and productivity, and can be a challenging condition to manage in primary care. As a majority of these patients have poor or only partial symptom control in primary care, they may be suitable for referral to secondary care. Some of these patients may be appropriate for treatment with specific allergen immunotherapy and this article reviews the impact of severe seasonal allergic rhinitis and highlights recent data on the effectiveness of sublingual immunotherapy. INNOVATIONWhat is IMPRESS? In the current political and social environment, health care is changing at a frenetic pace and nurses may feel that they are being left behind. The British Thoracic Society (BTS) and General Practice Airways Group (GPIAG) support and represent practitioners with an interest in secondary and primary care respectively. They have set up a joint initiative called IMPRESS to help respiratory clinicians to understand what is going on and how to get involved. This article gives an update on what the initiative is, how it works and what it’s done so far. HAVE YOU HEARD?Have you Heard? POPULAR POPULAR Children with a cough commonly present to practice nurses. All children cough and often cough repeatedly, with the majority of episodes associated with self-limiting viral infections for which there are no effective treatments. Coughing can be highly distressing for the child and their family members, and can have a significant impact on a child’s sleep, play and performance in school. Although cough may often be related to diagnosis of asthma, this is by no means the only cause. The British Thoracic Society recently published guidelines for the assessment and management of cough in children up to 12 years of age without known lung disease. Practice nurses and their GP colleagues will find these new guidelines valuable for diagnosis and management of cough. This article summarises the main recommendations. |
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