How patient beliefs affect adherence to prescribed medication regimens.

This article analyses the evidence relating to patients' beliefs and adherence to prescribed medication regimens. Between 30% and 50% of patients question the appropriateness and effectiveness of their prescribed medication and often do not comply with their regimens, which means significant amounts of NHS cash is wasted on unused medications. A critical analysis of published literature from several electronic databases and professional journals was undertaken.

3,4-methylenedioxyamfetamine (ecstasy) use reduces cognition.

3,4-methylenedioxyamfetamine (MDMA, ecstasy) use reduces cognition by reducing levels of dopamine and serotonin in the central nervous system. This results in dose-related cognition impairment, particularly in complex cognitive skills, as well as causing disorders such as mood changes, hallucinations, altered perception amd memory loss. MDMA reduces the level of these neurotransmitters within the neural synapses by reducing the number of intraneural transporters to the synaptic clefts, increasing deactivation with the synapse and/ or increasing degradation with the pre- and postsynaptic neurons.

Current guidance on the management of acute coronary syndrome.

Acute coronary syndrome (ACS) describes a spectrum of symptoms arising from the development of atherosclerosis. The degree of myocardial ischaemia depends on plaque stability and the extent of vessel occlusion. This article examines underlying pathophysiological processes and reviews current guidance and principles of managing ACS through symptom control, reducing mortality and maximizing secondary prevention.

Hypertension - a contemporary approach to nursing care.

The incidence of hypertension is increasing as the number of patients with obesity and diabetes mellitus increases. Hypertension results when the peripheral vascular resistance is increased, the blood viscosity is elevated and/or the flow of blood through the main arteries is impeded. Chronic hypertension results in an enlarged heart, myocardial damage and lung and renal abnormalities.

Understanding changes in cardiovascular pathophysiology.

Cardiovascular pathophysiological changes, such as hypertension and enlarged ventricles, reflect the altered functions of the heart and its circulation during ill-health. This article examines the normal and altered anatomy of the cardiac valves, the contractile elements and enzymes of the myocardium, the significance of the different factors associated with cardiac output, and the role of the autonomic nervous system in the heart beat. It also explores how certain diseases alter these functions and result in cardiac symptoms.

Increasing research evidence in practice: a possible role for the consultant nurse.

Aims: To determine the extent to which clinical nursing practice has adopted research evidence. To identify barriers to the application of research findings in practice and to propose ways of overcoming these barriers.

Background: Way back in 1976, nursing and midwifery practice started adopting research evidence.

Reductionism and holism in coronary heart disease and cardiac nursing.

Reductionism and holism are two contrasting philosophies which provide scientific knowledge of disease processes, health dynamics and care interventions. While reductionism focuses on specific and perhaps narrow concepts, it enhances our in-depth knowledge of key health issues. Holism focuses on understanding how all the significant factors affecting the particular health issue are involved, so a more informed decision can be made about health intervention.

The physiological basis of reflexology and its use as a potential diagnostic tool.

Ill-health changes the anatomy and physiology of affected organs, some of which can be observed visually, elicited through physical examination or confirmed through biomedical analysis. Understanding how anatomical changes contribute to physiological signs and symptoms will help practitioners identify the pathology, appreciate its origin and development and justify prescribed interventions in a way which can be upheld by critical external scrutiny. Reflexology contributes to an holistic approach to care and has recently improved its credibility as a discipline which supports orthodox care.

Complementary therapies to reduce physiological stress in pregnancy.

Pregnancy is a period of enormous physio-pathological and psychosocial adaptation in a woman's life. Although it is usually a time of joy and anticipation, many women experience some degree of anxiety, concern and fear regarding their own health and that of their babies, as well as the approaching labour. Worry about social, financial, occupational and relationship issues can often add to their stress levels which increases the possibility of pregnancy complications.