Taking aspirin daily for at least 4 years reduces long-term risk of cancer death

Evid Based Nurs 2011;14:71 doi:10.1136/ebn1165 Systematic review with meta analysisElizabeth Ann Coleman

College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA Correspondence to Elizabeth Ann Coleman
Mail Slot 529, 4301 West Markham Street, Little Rock, AR 72205, USA; colemanann{at}uams.eduCommentary on: Rothwell PM, Fowkes FG, Belch JF, et al. Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet 2011; 377: 31– 41.

? The study findings that daily aspirin reduced cancer death by 20% need to be factored into guideline recommendations. The large effect size of aspirin, even in low dose, in preventing cancer may outweigh the small risk of stomach bleeds.

? It may be recommended that persons at age 40 take daily low-dose aspirin to prevent cancer, not just of adenocarinoma of the gastrointestinal tract but of adenocarinoma of other tumour sites.

? More trial data are needed on cancers that affect women, especially breast and gynaecological cancers.

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A characterisation of factors determining postoperative ileus after laparoscopic colectomy enables the generation of a novel predictive score

Evid Based Nurs 2011;14:69-70 doi:10.1136/ebn1166 Annette Bisanz

Nursing Department, University of Texas MD Anderson Cancer Center, Houston, Texas, USACorrespondence to Annette Bisanz
26 Grants Lake Circle, Sugar Land, TX 77479, USA; abisanz{at}mdanderson.orgCommentary on: Kronberg U, Kiran RP, Soliman MS, et al. A characterization of factors determining postoperative ileus after laparoscopic colectomy enables the generation of a novel predictive score. Ann Surg 2011; 253: 78– 81.

? Allows the identification of patients at risk for postoperative ileus (POI).

? Predictive information combined with evidence from the WHO provides guidelines to prevent POI.

? Improved preventive care can decrease the cost and length of hospital stays.

? Nurses can advocate for preventive measures even though they do not have prescriptive authority.

? Nurses can translate this information into their standard of care.

? Inspires nurses to get involved in the research process …

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People with Alzheimer's disease are at increased risk of hip fracture and of mortality after hip fracture

Evid Based Nurs 2011;14:78-79 doi:10.1136/ebn1160 Kilian Rapp

Department of Clinical Gerontology, Stuttgart and Institute of Epidemiology, Ulm University, Stuttgart, GermanyCorrespondence to Kilian Rapp
Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany; kilian.rapp{at}rbk.deCommentary on: Baker NL, Cook MN, Arrighi HM, et al. Hip fracture risk and subsequent mortality among Alzheimer's disease patients in the United Kingdom, 1988–2007. Age Ageing 2011; 40: 49– 54.

? People with Alzheimer's disease (AD) are a high-risk population for hip fractures.

? Mortality after a hip fracture is particularly high in such people. Therefore, prevention and management of potential causes like delirium and an early rehabilitation should be priorities in AD patients after a hip fracture.

AD as well as hip fractures increase exponentially with age. Both diseases are frequent and have a considerable effect on the person's function. Previous studies have demonstrated an association between AD and hip fractures. The objective of the study by Baker and colleagues was to evaluate whether AD is an independent risk factor for hip fractures. Furthermore, the study compared mortality after hip fracture in people with and without AD.

People with AD were identified by (1) diagnosis ‘AD’ …

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Efficacy of implementation intentions intervention on prevention of smoking among adolescents

Evid Based Nurs 2011;14:81-82 doi:10.1136/ebn1162 Maria Margarida da Silva Reis dos Santos Ferreira

Nursing College of Porto, Porto, PortugalCorrespondence to Maria Margarida da Silva Reis dos Santos Ferreira
Escola Superior de Enfermagem do Porto, Rua Doutor António Bernardino de Almeida, 4200-072 Porto, Portugal; mrs{at}esenf.pt Commentary on: Conner M, Higgins AR. Long-term effects of implementation intentions on prevention of smoking uptake among adolescents: a cluster randomized controlled trial . Health Psychol 2010; 29: 529– 38.

? Implementation intention interventions which address the adolescent's intentions for the adoption of a healthy lifestyle are one of the strategies to use to avoid the adoption of risk behaviours and therefore improve their healthy behaviours.

? Implementation intention interventions are a strategy to control the consumption of tobacco in adolescence. These interventions should be started early to empower adolescents.

? Interventions which aim at health promotion should not be performed in isolation but should be repeated over a period of time.

? To prove the viability of randomised controlled trial (RCT, considered the best study design to evaluate the effect of an intervention) with long-time follow-up of studies developed with adolescents.

Nurses are in a unique position to promote the health of adolescents by developing formal and informal health education sessions. These interventions aim to develop the adolescent's personality, the acquisition of knowledge, critical-reflexive capacity, decision-making skills and the capacity of the adolescent to assess their own actions.

Research is essential to obtain gains …

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The organisational culture of nursing staff providing long-term dementia care is related to quality of care

Evid Based Nurs 2011;14:88-89 doi:10.1136/ebn1158 Claire Goodman

Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UKCorrespondence to Claire Goodman
Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire AL10 9AB, UK; c.goodman{at}herts.ac.ukCommentary on: van Beek AP, Gerritsen DL. The relationship between organizational culture of nursing staff and quality of care for residents with dementia: questionnaire surveys and systematic observations in nursing homes. Int J Nurs Stud 2010; 47: 1274– 82.

? Structured approaches that enable nursing staff to consider the culture of care they work within are likely to support reflection, critical discussion and improved quality of care.

? The physical and psychosocial care environment, characteristics of the nursing work and nursing staff, influence the well-being of people with dementia.

? Understanding how organisational culture can influence the quality of care is an important topic for nursing research.

? How the culture of care affects residents' quality of life and health outcomes needs further research.

? Intervention studies in care homes need to consider how to assess organisational context and culture and how different cultural contexts influence outcomes.

As the population ages and more people require long-term care, how the culture of a nursing …

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What is a systematic review?

Jane ClarkeCorrespondence to Jane Clarke
4 Prime Road, Grey Lynn, Auckland, New Zealand; janeclarkehome{at}gmail.comA high-quality systematic review is described as the most reliable source of evidence to guide clinical practice. The purpose of a systematic review is to deliver a meticulous summary of all the available primary research in response to a research question. A systematic review uses all the existing research and is sometime called ‘secondary research’ (research on research). They are often required by research funders to establish the state of existing knowledge and are frequently used in guideline development. Systematic review findings are often used within the …

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Using research findings in nursing practice

Alison TwycrossCorrespondence to Alison Twycross
Reader in Children's Nursing, Faculty of Health and Social Care Science, Kingston University- St George's University of London, London SW17 0RE, UK; a.twycross{at}sgul.kingston.ac.ukWelcome to the July edition of Evidence-Based Nursing ( EBN). In this edition, there are two new features which we hope will enable readers to use evidence in practice more effectively. The first of these is the Research Made Simple series. This will provide a one-page overview about key areas of research with the aim of increasing readers' understanding of the research process. The first article in the series, written by Jane Clarke, one of the associate editors for the journal, identifies the key features of a systematic review. Other articles in the series will explore other areas of research including ‘what is a randomised controlled trial?’ and ‘qualitative data analysis’.

The other new item in this edition is the Resource Page. This page will be included in each edition of the journal and will bring together new and updated sources of information about current evidence for nursing practice. Information has been collated from the Cochrane Nursing Network, …

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Jelang Pemilu 2014, Data Pemilih Dibenahi

Salah satunya lewat penerapan Single Identity Number.

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Demokrat Bantah Kembalikan Panggilan KPK

"Fraksi Partai Demokrat hanya tembusan, dan sudah kami teruskan," kata Jafar Hafsah.

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Mega: Benang Merah Sejarah Sengaja Diputus

Sebuah bangsa itu tidak akan mungkin bisa survive kalau tidak mengetahui sejarah.

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Diprediksi Suara Turun, Demokrat Tak Khawatir

"Ini lumrah. Naik turun sebuah partai itu wajar," kata Saan Mustopa.

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Psychosocial and information needs of people affected by colorectal cancer are poorly met during follow-up

Evid Based Nurs 2011;14:65-66 doi:10.1136/ebn1153 Lisa Kidd

Institute for Applied Health Research, School of Health, Glasgow Caledonian University, Glasgow, UKCorrespondence to Lisa Kidd
Institute for Applied Health Research, School of Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK; lisa.kidd{at}gcu.ac.ukCommentary on: Beaver K, Latif S, Williamson S, et al. An exploratory study of the follow-up care needs of patients treated for colorectal cancer. J Clin Nurs 2010; 19: 3291– 300.

? Follow-up and aftercare services for people affected by colorectal cancer should place more emphasis on aspects of patient needs (such as quality of life, lifestyle advice, psychosocial issues, information needs and self-management) in making the transition into the survivorship period. Nurses have a key role to play in this.

? Nurse-led models of follow-up may be favourable in providing information tailored towards patient needs and outcomes; more research is needed in this area to determine feasibility, acceptability and impact on outcomes.

Follow-up is typically the phase in which people affected by cancer enter on completion of primary treatment. There is considerable variation in models of follow-up, dependent on cancer type, clinician preferences and local guidelines. For people affected by colorectal cancer, this usually involves hospital outpatient review at regular, but decreasing, intervals over a period of several years and typically involves investigations such as blood tests, CT …

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Avoid benzodiazepines and opioids in people at risk of delirium

Evid Based Nurs 2011;14:75-76 doi:10.1136/ebn1155 David Phillip Alldred

Academic Unit of Medicines Management, Leeds Institute of Diagnostics and Therapeutics, School of Healthcare, University of Leeds, Leeds, UK Correspondence to David Phillip Alldred
Academic Unit of Medicines Management, Leeds Institute of Diagnostics and Therapeutics, School of Healthcare, University of Leeds, Leeds LS2 9JT, UK; d.p.alldred{at}leeds.ac.ukCommentary on: Clegg A, Young JB. Which medications to avoid in people at risk of delirium: a systematic review. Age Ageing 2011; 40: 23– 9.

? Patients at risk of delirium should have their medications reviewed with particular attention paid to benzodiazepines and opioids.

? Benzodiazepines should not be newly prescribed to people at risk of delirium and should be discontinued or reduced if possible.

? Opioids should be avoided in people at risk of delirium; however, this may be difficult in practice if moderate to severe pain is present.

? Patients who are receiving medications associated with delirium and are at risk of delirium should be closely monitored for changes or fluctuation in behaviour.

? Adequately powered, high-quality, prospective studies are needed to determine the influence of individual medications and pharmacological classes on the risk of delirium.

? Polypharmacy is common in older people and delirium risk rises with age; therefore, the risk of combinations of medications on delirium needs to be studied.

? Research is needed on the effect of withdrawing and reducing the doses of medications associated with …

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Demokrat: Nazaruddin Depresi

Apakah Nazaruddin sudah mulai depresi? "Tentu termasuk depresi seperti itu," tambah Jafar.

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PAN: Ambang Batas Jangan Matikan Demokrasi

Efektivitas dan stabilitas pemerintahan presidensial tidak ditentukan oleh jumlah partai.

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Bambang Soesatyo: KPK Tidak Taktis

Bentuk perlawanannya bisa saja menjadi tidak kooperatif dengan penegak hukum.

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Skin protection wheelchair cushions for older nursing home residents reduce 6-month incidence of ischial tuberosity pressure ulcers compared with segmented foam cushions

Evid Based Nurs 2011;14:79-80 doi:10.1136/ebn1167 Dimitri Beeckman1,2, Katrien Vanderwee2

1King's College London, Florence Nightingale School of Nursing & Midwifery, Department of Adult Nursing, London, UK

2Ghent University, Department of Public Health, Nursing Science Unit, Belgium Correspondence to Dimitri Beeckman
James Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK; dimitri.beeckman{at}kcl.ac.ukCommentary on: Brienza D, Kelsey S, Karg P, et al. A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions. J Am Geriatr Soc 2010; 58: 2308– 14.

? A pressure redistributing wheelchair cushion, used in a fitted wheelchair, is recommended to reduce the incidence of sitting-acquired pressure ulcers in nursing home residents.

? Selecting a wheelchair cushion must be a thought-out and well-advised decision and must be based on the expertise of a multidisciplinary team specialised in seating and mobility.

? Wheelchair fit and function must be monitored and adjusted frequently to avoid missing foot and arm rests which may cause more pressure and shear on the bony prominences.

? More research is needed to study the effect of repositioning protocols (posture and frequency) for at-risk patients seated in a wheelchair.

When seated in a chair, the body weight causes the greatest exposure to pressure over the ischial tuberosities. …

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An evidence-based communication skills training programme for oncology nurses improves patient-centred communication, enhancing empathy, reassurance and discussion of psychosocial needs

EBN Resources page

http://dtb.bmj.com

¦ Reducing non-steroidal anti-inflammatory drug (NSAID)-induced gastrointestinal complications: this article discusses evidence and offers advice on management strategies for reducing gastrointestinal complications associated with NSAID therapy. It is accompanied by an MCQ-based CME/CPD module.

Other articles include:

¦ Postexposure prophylaxis for HIV: this article discusses evidence and current guidelines on the use of antiretroviral drug therapy to prevent transmission of HIV infection through occupational or non-occupational exposure to the virus. It is accompanied by an MCQ-based CME/CPD module.

¦ Pain management programmes for chronic pain: this article reviews evidence and discusses the place of multidisciplinary pain management programmes for patients with chronic non-cancer pain. It is accompanied by an MCQ-based CME/CPD module.

http://itunes.com/apps/signguidelines

The apps for the Apple iPhone, iPod touch and …

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A 12-month intensive supervised exercise intervention and counselling reduces HbA1c, blood pressure and other modifiable cardiovascular risk factors in people with type 2 diabetes

The Use of Pediatric Early Warning Scores in the Emergency Department - Corrected Proof

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Knowledge Assessment and Preparation for the Certified Pediatric Emergency Nurse Examination - Corrected Proof

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Evolution of a Triage and Flow Process During a Joint American-Chinese Medical Mission in Dali, Yunnan, China - Corrected Proof

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Child Occupants and Side-Impact Crashes: Commentary - Corrected Proof

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Emergency Department Triage: What Data are Nurses Collecting? - Corrected Proof

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Strange Medication Reactions - Corrected Proof

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Intravenous HYDROmorphone: Can You Manage the Risk? - Corrected Proof

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Let the Data Speak: Decreasing Hemolysis Rates Through Education, Practice, and Disclosure - Corrected Proof

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Reviews of Books, Videos, CDs, Audiotapes, Web Sites, and More, Written by Emergency Nurses - Corrected Proof

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Motivational Interviewing for Emergency Nurses - Corrected Proof

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Emergency Nurses' Perceived Barriers to Demonstrating Caring When Managing Adult Patients' Pain - Corrected Proof

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Elevated Blood Pressure in ED Patients: Best Evidence on the Importance of Assessment, Recognition, and Referral - Corrected Proof

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Improving Patient Outcomes with Compression-Only CPR: Will Bystander CPR Rates Improve? - Corrected Proof

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Female Genital Injury Following Consensual and Nonconsensual Sex: State of the Science - Corrected Proof

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Ethical Issues of Hospital Crowding Solutions - Corrected Proof

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Under-triage as a Significant Factor Affecting Transfer Time Between the Emergency Department and the Intensive Care Unit - Corrected Proof

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Needlestick and Sharp Object Injuries Among Health Care Workers in Hamadan Province, Iran - Corrected Proof

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Ethical Decision Making in the Emergency Department: The Golden Rule - Corrected Proof

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An Australian Audit of ED Pain Management Patterns

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Synthetic Cannabinoids

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Knowledge Assessment and Preparation for the Certified Emergency Nurses Examination

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CE Enrollment Form

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Community Solutions to the Surge of Psychiatric Patients in Emergency Departments

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Education and Culture: Mitigation for Workplace Violence

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Conducting Triage Research: Lessons Learned in a Pediatric Emergency Department

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Earn Up to 9 Contact Hours by Reading the Designated Articles and Taking These Post Tests

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Reflections of Emergency Care Past and Present in the Tuscan Region of Italy

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One Nurse, One Life, Many Legacies: A Tribute: Nancy Kostel-Donlon, July 10, 1958-September 17, 2010

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Using Theory to Guide Injury Prevention Activities

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The Impact of Education on Provider Attitudes Toward Family-Witnessed Resuscitation

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Passing of a Past President

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May 2011 Clinical CE test

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Cutting-Edge Discussions of Management, Policy, and Program Issues in Emergency Care

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The Trauma Charge Nurse in the Pediatric Emergency Department

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Research Test Questions

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Palliative and End-of-Life Care in the Emergency Department: Guidelines for Nurses

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Prioritizing Patients with Acuity 3

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The Four Horsemen of the Apocalypse of Trauma

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Controlling Aggressive Behavior in the Geriatric Patient

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Information for Readers

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Who Is Sleeping in Our Beds? Factors Predicting the ED Boarding of Admitted Patients for More Than 2 Hours

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Table of Contents

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Endocrine Emergencies

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Editorial Board

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Caring for the Caregiver: Moving Beyond the Finger Pointing After an Adverse Event

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Emergency Nursing Resource: Needle-Related Procedural Pain in Pediatric Patients in the Emergency Department

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Are You a Good Witch or a Bad Witch?

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Effect of Education on a Chest Pain Mnemonic on Door-to-ECG Time

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Professional/Administrative Test Questions

European Online Customer Service
The Boulevard
Langford Lane, Kidlington
Oxford. OX5 1GB
UK
Hours: Monday - Friday, 8:30am - 5:00pm (Greenwich Mean Time/British Summer Time)
Tel: +44 (0) 1865-843177 (Within Europe)
Fax: +44 (0) 1865-843970
E-mail: eurosupport@elsevier.com

North American and Rest of World Online Customer Service
6277 Sea Harbor Drive
Orlando. FL 32887-4800
USA
Hours: Monday - Friday, 7:30am - 6:00pm EST (Eastern Standard/Daylight Time)
Tel: (800) 654-2452 (Toll Free US & Canada)
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A 30-year-old Woman with Acute Leg Pain

European Online Customer Service
The Boulevard
Langford Lane, Kidlington
Oxford. OX5 1GB
UK
Hours: Monday - Friday, 8:30am - 5:00pm (Greenwich Mean Time/British Summer Time)
Tel: +44 (0) 1865-843177 (Within Europe)
Fax: +44 (0) 1865-843970
E-mail: eurosupport@elsevier.com

North American and Rest of World Online Customer Service
6277 Sea Harbor Drive
Orlando. FL 32887-4800
USA
Hours: Monday - Friday, 7:30am - 6:00pm EST (Eastern Standard/Daylight Time)
Tel: (800) 654-2452 (Toll Free US & Canada)
Tel: (407) 345-4299 (Outside US & Canada)
Fax: (407) 363-9661
E-mail: elspcs@elsevier.com

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