British journal of community nursing
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Br J Community Nurs · Apr 2015
Sample evaluation of caseload complexity in a community health-care NHS trust.
People diagnosed with a multiple long-term conditions and those with profound and multiple learning disabilities are the most intensive users of health and social care. In addition, around 30% of patients with long-term physical conditions also have a mental health problem. The close relationship between mental and physical health is reflected in the high frequency with which illnesses of both kinds overlap in an age of multi-morbidity. ⋯ This also affects their capacity to engage in treatment and make decisions, which affects not only their care and treatment but ultimately their quality of life. The NHS Call to Action demanded improvement in the service provided to support the needs of people with long-term conditions. The scale of the impact of comorbid mental health problems on costs and outcomes suggests that developing services that respond more effectively to these needs should be a priority.
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This article discusses the use of Microfine toe caps (Haddenham, UK) for the treatment of digit swelling. It will discuss the indications and contraindications of the device and offers some case studies where toe caps have been used in clinical practice. The use of the Microfine toe cap offers an alternative to toe bandaging, has many different applications and can be safe and time-saving to apply when used appropriately following a full and holistic assessment.
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Metastatic spinal cord compression (MSCC) is a potentially life changing oncological emergency. Neurological function and quality of life can be preserved if patients receive an early diagnosis and rapid access to acute interventions to prevent or reduce nerve damage. Symptoms include developing spinal pain, numbness or weakness in arms or legs, or unexplained changes in bladder and bowel function. Community nurses are well placed to pick up on the 'red flag' symptoms of MSCC and ensure patients access prompt, timely investigations to minimise damage.