British journal of nursing (Mark Allen Publishing)
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Sickle cell disease (SCD) is a long-term condition that would benefit from a long-term conditions approach to its care and management. SCD is growing in prevalence, affecting 10,000-12,000 people in the UK, with SCD sufferers having an increased life expectancy from in the past. The most problematic aspect of managing SCD is management of the pain from vaso-occlusive crises. ⋯ A literature review was carried out to examine the management of vaso-occlusive pain in SCD. The review identified three main barriers to effective pain management in SCD: the manifestation of vaso-occlusive pain, the sociocultural factors affecting pain assessment, and the concerns regarding addiction and pseudo-addiction. Addressing these barriers will allow people with SCD to have their pain managed more effectively, improve their quality of life and potentially reduce A&E attendances and admissions to hospital.
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Comparative Study
Improving accuracy and efficiency of early warning scores in acute care.
Early warning scores (EWS) are an integral part of the care of acutely ill patients. Unfortunately, in the few studies where the accuracy of EWS has been tested it has been found to be lacking, with serious implications for quality of care. ⋯ A hand-held computer helps to improve the accuracy and efficiency of EWS in acute hospital care and is acceptable to nurses.
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Chronic obstructive pulmonary disease (COPD) is a potentially fatal, slowly progressive condition of the airways. It is a chronic disease which, although preventable, is not curable. ⋯ It is essential that healthcare professionals are able to recognize, which is not always easy, when patients have reached this stage of the illness, to ensure appropriate care and management. This article provides an outline for healthcare professionals of clinical markers to help distinguish end-stage disease and pharmacological and non-pharmacological interventions that may assist in achieving optimal symptom control and provide some quality to the patient's final stage of their life.
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In most industrialized nations and many developing countries chronic diseases or non-communicable diseases (NCDs) are the leading cause of death. In 2005, chronic diseases, such as cardiovascular disease, cancer, respiratory disease and diabetes caused 58 million deaths worldwide (World Health Organization, 2005). ⋯ It further explores the impact of globalization as an important determinant of NCD epidemics. Finally, in addition to working alongside policy-makers, the fundamental roles of nursing to promote health, prevent disease and alleviate suffering call for expression of caring for humanity and environment through political activism at all levels to bring about reforms of current global economic order.
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Total hip replacement (THR) and total knee replacement (TKR) surgery are carried out for the relief of hip or knee pain, usually caused by osteoarthritis. This is the first of two articles on THR and TKR. ⋯ The organization of services along the patient pathway to ensure comprehensive preparation is considered and the nursing role highlighted. The second article, to be published in the next issue, will discuss recovery and rehabilitation from THR and TKR surgery.