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Issue 207 - 28 Nov 2011

Selected books - NZNO Library
These books can be borrowed by members free of charge, for a period of 4 weeks.

1.  Code Green: Money-driven hospitals and the dismantling of hospitals
By Dana Beth Weinberg, with a foreword by Suzanne Gordon
Published by ILR, 2003
Through a careful look at the effects of the restructuring strategies chosen and implemented by Beth Israel Deaconess Medical Center, the author examines management's efforts to balance service and survival. By showing the effects of hospital restructuring on nurses' ability to plan, evaluate, and deliver excellent care, Weinberg provides a stinging indictment of standard industry practices that underestimate the contribution nurses make both to hospitals and to patient care.

2. Dosage calculations made incredibly easy
4th edition, Published by Wolters Kluwer Health, 2010
This book will teach you all the important things you need to know about dosage calculations. It offers thorough reviews of basic maths including factions, decimals, percentages, and ratios and proportions. It includes vital information on key aspects of dosage calculations, such as preventing errors, deciphering difficult abbreviations, reading labels, and determining safe dosages for pediatric and elderly patients.

3.  Nurse prescribing
2nd edition. Edited by Jennifer Humphries & Joyce Green, with a foreword by Baroness Cumberlege.
Published by Palgrave, 2002
This book provides an essential and authorative guide to the principles and practice of nurse prescribing. New for this edition are separate chapters covering legal issues and ethical principles, and a whole chapter of case study scenarios that give the reader real-life examples of nurse prescribing in practice.


4. Editorial: Better management of chronic pain care for all.
By MacDonald, Noni al. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1815-1815
Chronic pain is no respecter of age, wealth or status. Ramage-Morin has estimated that 500 000 Canadians aged 12 to 44 years, 38% of seniors in long-term care facilities and 27% of seniors living at home experienced pain on a chronic basis.1,2 Worse still, a review of the European literature noted that effective pain control for patients in the primary care setting often eluded health practitioners.

5. Antidepressants, antiplatelets and bleeding: One more thing to worry about?
By Juurlink, David N. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1819-1820
: In 2010, more than 25 million prescriptions for selective serotonin reuptake inhibitor (SSRI) antidepressants were dispensed in Canada (Josiane Gaudet, Brogan IMS, Kirkland, Quebec: personal communication, 2011). How many of these were dispensed to patients also taking acetylsalicylic acid (ASA), clopidogrel or both is not known, but most clinicians recognize
that the concomitant use of antidepressants and antiplatelet drugs is common, particularly among elderly patients. But is the combination safe?

6. The efficacy and cost-effectiveness of statins in low-risk patients.
By Gupta, Ajay K. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1821-1823
[See related research article by Tonelli and colleagues at and synopsis on page 1845, and related research article by Conly and colleagues at and synopsis on page 1846
Abstract: In this issue of the CMAJ, the results of two studies 1,2 have important implications for clinical practice, as well as for health care policy-makers.In their meta-analysis of 29 trials involving 80 711 participants, Tonelli and colleagues report that, among people at low cardiovascular risk, the use of statins significantly reduces cardiovascular morbidity and has important survival benefits compared with a placebo (relative risk 0.90, 95% confidence interval 0.84–0.97).1 Using these results, Conly and colleagues conducted a cost effectiveness study and reported that the lifetime use of statins among people at low cardiovascular risk is cost-effective under current international standards (i.e., willingness to pay, which is arbitrarily set at less than US$50 000 per quality adjusted life-year gained in the United States and Canada, and less than £30 000 in the United Kingdom).These messages may potentially affect the decision-making of millions of Canadians and thus require careful consideration.

7. Chronic cerebrospinal venous insufficiency: A Kuhnian paradigm shift or another fad?
By Fox, Robert J. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1824-1825
Multiple sclerosis is a chronic demyelinating disorder affecting the brain, spinal cord and optic nerves. Although the cause of multiple sclerosis is unknown, pathologic studies suggest that the patient’s immune system inappropriately attacks the myelin sheath covering axons. All currently approved disease modifying treatments for multiple sclerosis target
the immune system in one way or another.

8. Back to black bag and horse-and-buggy medicine.
By Walkinshaw, Erin. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1829-1830
The case for house calls is compelling, particularly in an era in which treatment of chronic diseases is consuming more of the health care dollar and more senior citizens need care. But financial incentives for physicians to return to black bag and horse-and-buggy medicine haven’t followed suit.

9. Mandatory vaccinations: No middle ground.
By Walkinshaw, Erin. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1830-1831
Few issues generate such impassioned debate as mandatory vaccination policies. Advocates say vaccines are safe and exemptions should be minimal. Opponents counter that vaccines are hazardous to health and that any limitation on exemptions is a violation of constitutional rights.

10. Risk of bleeding associated with combined use of selective serotonin reuptake inhibitors and antiplatelet therapy following acute myocardial infarction
By Labos, Christopher et al. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16:p1835-1843
Background: Patients prescribed antiplatelet treatment to prevent recurrent acute myocardial infarction are often also given a selective serotonin reuptake inhibitor (SSRI) to treat coexisting depression. Use of either treatment may in crease the risk of bleeding. We assessed the risk of bleeding among patients taking both medications following acute myocardial infarction.
Methods: We conducted a retrospective co hort study using hospital discharge abstracts, physician billing information, medication re imbursement claims and demographic data from pro - vincial health services administrative databases. We included patients 50 years of age or older who were discharged from hospital with anti -platelet therapy following acute myocardial infarction be tween January 1998 and March 2007. Patients were followed until admission to hospital due to a bleeding episode, admission to hospital due to recurrent acute myocardial infarction, death or the end of the study period.
Results: The 27 058 patients in the cohort received the following medications at discharge: acetylsalicylic acid (ASA) (n = 14 426); clopidogrel (n = 2467), ASA and clopidogrel (n = 9475); ASA and an SSRI (n = 406); ASA, clopidogrel and an SSRI (n = 239); or clopidogrel and an SSRI (n = 45). Compared with ASA use alone, the combined use of an SSRI with antiplatelet therapy was associated with an increased risk of bleeding (ASA and SSRI: hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.08-1.87; ASA, clopidogrel and SSRI: HR 2.35, 95% CI 1.61-3.42). Compared with dual antiplatelet therapy alone (ASA and clopidogrel), combined use of an SSRI and dual antiplatelet therapy was associated with an increased risk of bleeding (HR 1.57, 95% CI 1.07-2.32). Interpretation: Patients taking an SSRI together with ASA or dual antiplatelet therapy following acute myocardial infarction were at increased risk of bleeding. [ABSTRACT FROM AUTHOR].

11. Considerations when prescribing trimethoprim-sulfamethoxazole.
By Ho, Joanne al. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1851-1858
: Introduced in 1968, trimethoprim–sulfamethoxazole remains a popular antibiotic because of its low cost, effectiveness and familiarity among clinicians. It is the most frequently prescribed antibiotic for urinary tract infections in Canada.1 Other indications include treatment of infections caused by Pneumocystis jiroveci, Toxoplasma gondii, Stenotrophomonas maltophilia and community-associated methicillin-resistant Staphylococcus aureus.

12. Alcohol consumption and cancer risk: revisiting guidelines for sensible drinking.
By: Latino-Martel, Paule et al. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1861-1865
Recommendations for what constitutes sensible drinking are not new and have varied across time and place. In 1981, concerned by the increase in admissions to hospital for alcohol-related diseases in the United Kingdom, health educators and clinicians developed the general concept of sensible drinking. Drinking sensibly was defined as the opposite of alcohol misuse, which is “drinking to excess or drinking in situations which are not appropriate when the effect in either case is to put the drinker or others at risk of harm.”

13. A breast mass in a 56-year-old man.
By MacFadden, Derek al. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1875-1878
A 56-year-old man living in Toronto, Ontario, presented to his family physician after finding a lump in his right breast on self-inspection. He described a one month history of pressure and tenderness at the site of the mass.

14. Idiopathic intracranial hypertension.
By Belliveau, Michel J.& ten Hove, Martin W. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1881-1881
Idiopathic intracranial hypertension primarily affects young obese women More than 93% of people with idiopathic
intracranial hypertension (previously called pseudotumour cerebri and benign intracranial hypertension) are obese.

15. Calciphylaxis: a severe complication of renal disease.
By Scola, Nina & Kreuter, Alexander. CMAJ: Canadian Medical Association Journal, 11/8/2011, Vol. 183 Issue 16: p1882-1882
An 82-year-old man with end-stage renal disease, who had been receiving hemodialysis for five years, presented with a three-month history of erythematous patches on his legs. Clinical examination showed multiple painful cutaneous ulcerations coated with dark eschar, surrounded by indurated, violaceous plaques (Figure 1).

Journals - Table of Contents

16. From International Nursing Review, Official Journal of the International Council of Nurses
Volume 58, Number 4, 4 December 2011

Nursing and health policy perspectives
Delivering and securing health care in challenging times (pages 401–402)
16B. Plagiarism or differing ways of representing knowledge? (page 403)
16C. Promoting access to health care: a nursing role and responsibility (page 404)
International perspectives
Supporting nurses in caring for their communities: a conversation with Linda Carrier-Walker (pages 405–407)
16E. GCEF coordinators build capacity and leadership skills (pages 407–410)
16F. Nurses share knowledge at first ICN Workforce Forum for Latin America (pages 410–412)
Many paths lead to nursing: factors influencing students' perceptions of nursing (pages 413–419)
16H. Nursing students' perceptions of nursing: a descriptive study of four cohorts (pages 420–427)
16I. Exchange students crossing language boundaries in clinical nursing practice (pages 428–433)
Quality improvement
Patient safety: nursing students' perspectives and the role of nursing education to provide safe care (pages 434–442)
16K. Children's knowledge of cancer diagnosis and treatment: Jordanian mothers' perceptions and satisfaction with the process (pages 443–449)
16L. The breast care nurse: the care specialist in breast centres (pages 450–453)
Clinical issues
Occupational exposure to HIV: a conflict situation for health workers (pages 454–462)
16N. Factors affecting peritoneal dialysis selection in Taiwanese patients with chronic kidney disease (pages 463–469)
16O. Factors associated with delayed hospital arrival among patients with acute myocardial infarction: a cross-sectional study in Greece (pages 470–476)
16P. Condom promotion in Belize: self-efficacy of Belizean nurses (pages 477–483)
16Q. Religion, culture and male involvement in the use of the Standard Days Method: evidence from Enugu and Katsina states of Nigeria (pages 484–490)
16R. Help-seeking behaviours in childbearing women in Ghana, West Africa (pages 491–497)
16S. Nurses' and midwives' work-life experiences
16T. Factors influencing midwifery migration from the United Kingdom to Australia (pages 498–504)
16U. Nurse teachers' working lives: a questionnaire survey of nursing schools in Mainland China (pages 505–511)

News - National

17. How Parliament Works
Some guidelines for new MP's

18. Voting to stay optional despite record low turnout
TVNZ - 28 November 2011
Voter turnout was the lowest in more than 100 years on Saturday based on the percentage of people eligible to vote, but Prime Minister elect John Key is not considering introducing compulsory voting. The Electoral Commission has estimated voter turnout for Saturday's election to be 73.83% of those enrolled as at 5pm Friday.

News - International

19. Nation shifts to spend more on welfare than health Jessica Wright
Sydney Morning Herald - November 26, 2011.
SPENDING on welfare payments and services outstripped the entire national health budget by a hefty $34 billion during 2008-09, before taking unemployment benefits into account. A biennial snapshot of the nation's welfare was issued by the Australian Institute of Health and Welfare this week and showed more than one million adults aged 18-34 were still living at home, almost half citing financial pressures as the reason for doing so

20. Hospital guide: death rates 10 per cent higher at weekends
Patients admitted to NHS hospitals for emergency treatment at weekends are almost 10 per cent more likely to die than during the rest of the week, according to a comprehensive new report.
The Telegraph

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