An education programme for professionals who specialize in substance misuse in St. Petersburg, Russia: part 2.

This paper extends the account of a joint project of education and training of doctors and nurses in St. Petersburg, Russia funded by the Know How Fund Health Sector Small Partnership Scheme (Russia) (). It reports the findings of two evaluations of the project.

Respecting a patient's care needs after death.

The delivery of care to patients who have died is a nursing intervention that most nurses will have to perform at some time. This article aims not only to provide the rationale behind the care given to patients during last offices, but also to explore the professional, legal and ethical considerations that must be addressed within the provision of holistic care.

Nutrient insult in early pregnancy.

Nutrient insults in early pregnancy, such as nutrient deprivation during famines, are often associated with an unfavourable outcome. Suboptimal nutrition in the early stage of gestation has been linked to a number of adverse effects on fetal growth and development. Historically, nausea and vomiting in pregnancy (NVP) was an important contributor to pregnancy-related mortality; indeed, Charlotte Bronte died from starvation and dehydration after suffering very severe NVP 4 months into her first pregnancy (Gaskell, 1858).

Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb.

Objectives: To investigate potential interactions between physical and psychosocial risk factors in the workplace that may be associated with symptoms of musculoskeletal disorder of the neck and upper limb.

Methods: 891 of 1514 manual handlers, delivery drivers, technicians, customer services computer operators, and general office staff reported on physical and psychosocial working conditions and symptoms of neck and upper limb disorders using a self administered questionnaire (59% return rate). Of the 869 valid questionnaire respondents, 564 workers were classified in to one of four exposure groups: high physical and high psychosocial, high physical and low psychosocial, low physical and high psychosocial, and low physical and low psychosocial.

Enhancing creativity to improve palliative care: the role of an experiental self-care workshop.

Creativity plays an important part in all aspects of life. Although the nature of creativity is hypothesized in a variety of ways, there is no common agreement as to how or why it manifests. In the USA and UK, creative ability is often restricted by education, and nursing education programmes appear to be no exception.

Nursing the clinic, being there and hovering: ways of caring in a British fertility unit.

Aim: To explore the meaning of caring in a fertility unit and to present the findings and discuss their implications for practice.

Background: Little research has been published internationally on the nature of nursing care in the fertility field. This study was intended to stimulate debate over the nature of care in fertility work.

An education programme for professionals who specialize in substance misuse in St Petersburg, Russia: part 1.

This paper provides an account of a joint project of education and training of doctors and nurses in St Petersburg, funded by the Know How Fund Health Sector Small Partnership Scheme (Russia). Contextual material on drug and alcohol misuse in Russia is introduced prior to a focus on the drug and alcohol misuse issues in St Petersburg. Reference is made to historical and contemporary material on alcohol and drug misuse, and attention is drawn to the reliability of statistical data.

The conversational and discursive construction of community psychiatric nursing for chronically confused people and their families.

The paper examines the conversational and discursive processes that occur within domiciliary visits between community psychiatric nurses (CPNs) and relatives of chronically confused people. Three conversation formats are identified, through which talk between CPNs and carers is organised. In addition, various discursive practices are also identified within domiciliary meetings.

Differential effects of left and right cerebral vascular accidents on language competency.

While language facility was once considered to be the sole province of the "dominant" left hemisphere, clinical and experimental findings suggest the right hemisphere plays an equally important role in many language tasks. To elucidate differential hemispheric language processes, Right Hemisphere Language Battery and Western Aphasia Battery data from left (LHD) and right (RHD) hemisphere cerebral vascular accident (CVA) patients and controls were subjected to multivariate discriminant analysis. The highly significant group differences and overall 95% classification rate obtained confirms the utility of the dependent measures in differential diagnosis.

Implementing a psychological intervention to improve lifestyle self-management in patients with type 2 diabetes.

Lifestyle and behavioural factors play an important role in the development of Type 2 diabetes and management of this illness involves a combination of medication and lifestyle change. However, diabetes lifestyle programs have been found unsuccessful unless they are intensive and continued over long periods of time. The present study, which is one of the few randomised controlled trials of lifestyle interventions to be conducted outside of the US, aims to evaluate a brief psychological intervention that can be integrated into routine usual care to assist people to make the recommended lifestyle changes.

A UK general practice database study of prevalence and mortality of people with neural tube defects.

Objective: To investigate the prevalence of neural tube defects (NTDs) in the UK and to compare the mortality rate with that of the general population.

Methods: A cross-sectional study. The General Practice Research Database (GPRD) contains the prescribing and diagnostic records since 1990 of over 4 million people from throughout the UK.

Venous thromboembolism and combined oral contraceptives: does the type of progestogen make a difference?

Venous thromboembolism (VTE) is rare in young women but is associated with the use of combined oral contraceptives (OCs). In 1995 and 1996, three studies showed a difference in the risk of VTE with third-generation OCs containing the progestogens, desogestrel or gestodene, compared with earlier formulations. However, the subsequent MediPlus study did not show any difference in the risk of VTE between users of third- and second-generation OCs.

Substance misuse in Russia: a partnership for policy change and service development.

The paper provides an account of a joint project of education and training of doctors and nurses in St. Petersburg, funded by the Know How Fund Health Sector Small Partnership Scheme (Russia). Contextual material on substance misuse in Russia is introduced prior to focussing on the situation in St.

Classifying clinical decision making: interpreting nursing intuition, heuristics and medical diagnosis.

This is the second of two linked papers exploring decision making in nursing. The first paper, 'Classifying clinical decision making: a unifying approach' investigated difficulties with applying a range of decision-making theories to nursing practice. This is due to the diversity of terminology and theoretical concepts used, which militate against nurses being able to compare the outcomes of decisions analysed within different frameworks.

Classifying clinical decision making: a unifying approach.

This is the first of two linked papers exploring decision making in nursing which integrate research evidence from different clinical and academic disciplines. Currently there are many decision-making theories, each with their own distinctive concepts and terminology, and there is a tendency for separate disciplines to view their own decision-making processes as unique. Identifying good nursing decisions and where improvements can be made is therefore problematic, and this can undermine clinical and organizational effectiveness, as well as nurses' professional status.

The discursive construction of identity by community psychiatric nurses and family members caring for people with dementia.

This paper examines the discursive work undertaken by family members caring for people with dementia when interacting with community psychiatric nurses. The paper outlines the theoretical basis of this approach and brings it to bear upon data taken from a study of home visits to family carers by community psychiatric nurses. The paper provides insights into the way family carers and welfare agencies manage their interface through the use of language.

Hospital nurses' job satisfaction, individual and organizational characteristics.

Hospital nurses' job satisfaction, individual and organizational characteristics Using the Ward Organizational Features Scales (WOFS), relationships between aspects of the organization of acute hospital wards, nurses' personal characteristics and nurses' job satisfaction are examined among a nationally representative sample of 834 nurses in England. The analysis contributes to a growing body of evidence demonstrating the importance of interpersonal relationships to nurses' job satisfaction. In particular, the positive contribution of the cohesiveness of ward nursing staff is highlighted, but the potential for many current NHS staffing strategies and work environments to undermine the development of cohesive working relationships is also noted.

The use of the Mini-Nutritional Assessment (MNA) tool in elderly orthopaedic patients.

Objective: To assess the use of the Mini-Nutritional Assessment (MNA) in elderly orthopaedic patients.

Design: An observation study assessing the nutritional status of female orthopaedic patients.

Setting: The orthopaedic wards of the Royal Surrey County Hospital.

South Asian patients' lived experience of acute care in an English hospital: a phenomenological study.

Studies on utilization of hospital services by South Asian patients in the United Kingdom have consistently demonstrated levels of dissatisfaction with care in relation to meeting religious and cultural needs, although there are few studies on minority ethnic patients' utilization of acute hospital services. This study aimed to describe and interpret from the consumer's view the 'lived experience' of acute hospital care from the perspectives of South Asian patients and their family carers. The purposive sample of 10 patients and six carers consisted of 13 females and three males (five Hindus, six Muslims and five Sikhs) who were interviewed at home 2 to 3 weeks after discharge from hospital.

Medical therapy for benign prostatic hyperplasia: a review of the literature.

Objective: To review the existing evidence regarding the efficacy and safety of medical therapy for lower urinary tract symptoms (LUTS) indicative of benign prostatic hyperplasia (BPH). To assess randomised controlled trials investigating the six alpha-adrenergic receptor antagonists (alpha-blockers), prazosin, alfuzosin, indoramin, terazosin, doxazosin, and tamsulosin, that benefit patients by relaxing prostatic smooth muscle, and the anti-androgen, finasteride, that mediates its more long-term benefits by reducing prostate size.

Results: This review suggests that both classes of drug offer significant improvement in criteria used to evaluate symptomatic BPH and can be effective whilst being acceptably safe.

Validation of the diagnosis of venous thromboembolism in general practice database studies.

Aims: The study was conducted to determine whether the method for selecting cases of venous thromboembolism (VTE) from general practice databases significantly affected the findings of an epidemiological study.

Methods: Cases of VTE were identified from the UK General Practice Research Database (GPRD) by searching for codes for deep vein thrombosis (DVT) and pulmonary embolism (PE). These had to be supported by evidence of anticoagulation and be exposed to a combined oral contraceptive (COC) at the time of the event.