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Issue 17 - 5 June 2012


1. Bowel cancer: The Journal for Nurses in General Practice
By Newson, Louise. Practice Nurse 37. 7 (Apr 10, 2009): 12-15.
Bowel cancer is a common cancer in the UK that is treatable if diagnosed early. It is hoped that the introduction of the bowel cancer screening programme will lead to earlier diagnosis of bowel cancer and a reduction in related morbidity and mortality. People still need to be made aware of the common symptoms of bowel cancer, so they can present early to their GP for prompt referral and investigations.
Source: Proquest Nursing and Allied Health database

2. The views of bowel cancer survivors and health care professionals regarding survivorship care plans and post treatment follow up
By Baravelli, Carl; Krishnasamy, Meinir; Pezaro, Carmel; Schofield, Penelope; Lotfi-jam, Kerryann; et al.
Journal of Cancer Survivorship 3. 2 (Jun 2009): 99-108
: Increasing numbers of people survive cancer beyond diagnosis and treatment. Many survivors have ongoing needs and they may encounter fragmented, poorly coordinated follow up care. Survivorship care plans (SCP) have been promoted as a key aspect of survivorship care. This study aimed to survey key stakeholders in the care of people with colorectal cancer(survivors, primary care providers and hospital-based healthcare professionals) regarding follow-up and SCP. In study 1, cancer survivors completed a questionnaire regarding their follow-up and experiences during survivorship. Participants' primary care physicians completed a phone interview regarding proposed SCP elements. A subgroup of survivors reviewed a sample SCP and participated in a phone interview regarding this. In study 2, healthcare professionals working with colorectal cancer patients completed a questionnaire regarding follow-up and proposed elements of a SCP. Twenty survivors completed the questionnaire, 14 primary care providers completed a phone interview and 12 survivors reviewed the sample SCP. Ninety-five healthcare professionals (30 medical professionals and 65 nurses) completed the questionnaire. There was strong support for core elements of the SCP. Additionally, nurses and survivors expressed support for supportive care and psychosocial elements. There was lack of consensus regarding who should prepare and discuss the SCP. There is strong support for the development and use of SCPs for bowel cancer survivors. There is some variation in opinion regarding ideal content of the SCP, who might prepare it, and how it might be discussed and utilised. Overcoming identified barriers to implementing SCPs for bowel cancer survivors is necessary for high quality cancer care. 
Source: Proquest Nursing and Allied Health database

3. Colonoscopic surveillance improves survival after colorectal cancer diagnosis in inflammatory bowel disease
By Lutgens, M W M D; Oldenburg, B; Siersema, P D; Van Bodegraven, A A; Dijkstra, G; et al. The British Journal of Cancer 101. 10 (Nov 17, 2009): 1671-5
Colonoscopic surveillance provides the best practical means for preventing colorectal cancer (CRC) in inflammatory bowel disease (IBD) patients. Strong evidence for improved survival from surveillance programmes is sparse. The aim of this study was to compare tumour stage and survival of IBD patients with CRC who were a part of a surveillance programme with those who were not. A nationwide pathology database (PALGA (pathologisch anatomisch landelijk geautomatiseerd archief)) was consulted to identify IBD patients with CRC treated in all eight university hospitals in The Netherlands over a period of 15 years. Patients were assigned to the surveillance group when they had undergone one or more surveillance colonoscopies before a diagnosis of CRC. Patients who had not undergone surveillance served as controls. Tumour stage and survival were compared between the two groups. A total of 149 patients with IBD-associated CRC were identified. Twenty-three had had colonoscopic surveillance before CRC was discovered. The 5-year CRC-related survival rate of patients in the surveillance group was 100% compared with 74% in the non-surveillance group (P=0.042). In the surveillance group, only one patient died as a consequence of CRC compared with 29 patients in the control group (P=0.047). In addition, more early tumour stages were found in the surveillance group (P=0.004). These results provide evidence for improved survival from colonoscopic surveillance in IBD patients by detecting CRC at a more favourable tumour stage.
Source: Proquest Nursing and Allied Health database

4. High expression of HSP47 in ulcerative colitis-associated carcinomas: proteomic approach
By Araki, K; Mikami, T; Yoshida, T; Kikuchi, M; Sato, Y; et al.
The British Journal of Cancer 101. 3 (Aug 4, 2009): 492-7
Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease, known to be associated with a markedly increased risk of colorectal carcinoma development.
Using proteomic analysis with two-dimensional gel electrophoresis and mass spectrometry, differentially expressed proteins were assessed between UC-associated cancer and sporadic colon cancer cell lines. Western blot and immunostaining were performed for confirming the expression. Heat-shock protein of 47 kDa (HSP47) was identified as one of the proteins expressed more highly in UC-associated cancer cell lines, and an immunohistochemical examination confirmed significantly higher levels of HSP47 in UC-associated colon cancers than in sporadic counterparts, the expression increasing with a progression of neoplastic lesions. Heat-shock protein of 47 kDa was further found to be coexpressed with type I collagen in the cytoplasm, and both HSP47 and type I collagen were released from cultured cells into the culture medium. These results suggest that overexpression of HSP47 is a unique characteristic of UC-associated carcinoma related to type I collagen synthesis, with possible clinical applications
Source: Proquest Nursing and Allied Health database

5. Celiac Disease and Risk of Subsequent Type 1 Diabetes: A general population cohort study of children and adolescents
By Ludvigsson, Jonas F; Ludvigsson, Johnny; Ekbom, Anders; Montgomery, Scott M. Diabetes Care 29. 11 (Nov 2006): 2483-8
Earlier studies suggest that children with type 1 diabetes are more likely to have a subsequent diagnosis of celiac disease. However, research is sparse on the risk of subsequent type 1 diabetes in individuals with celiac disease. We sought to determine the risk of subsequent type 1 diabetes diagnosed before the age of 20 years in children and adolescents with celiac disease in a national, general population-based cohort. We identified 9,243 children with a diagnosis of celiac disease in the Swedish national inpatient register between 1964 and 2003. We then identified five reference individuals matched at time of diagnosis for age, calendar year, sex, and county (n = 45,680). Only individuals with >1 year of follow-up after study entry (diagnosis of celiac disease) were included in the analyses. Celiac disease was associated with a statistically significantly increased risk of subsequent type 1 diabetes before age 20 years (hazard ratio 2.4 [95% CI 1.9-3.0], P < 0.001). This risk increase was seen regardless of whether celiac disease was first diagnosed between 0 and 2 (2.2 [1.7-2.9], P < 0.001) or 3 and 20 (3.4 [1.9-6.1], P < 0.001) years of age. Individuals with prior celiac disease were also at increased risk of ketoacidosis or diabetic coma before the age of 20 years (2.3 [1.4-3.9], P = 0.001). Children with celiac disease are at increased risk of subsequent type 1 diabetes. This risk increase is low considering that 95% of individuals with celiac disease are HLA-DQ2 positive.
Source: Proquest Nursing and Allied Health database

6. Celiac Disease and IgA Deficiency: Complications of Serological Testing Approaches Encountered in the Clinic
By McGowan, Kelly E; Lyon, Martha E; Butzner, J Decker. Clinical Chemistry 54. 7 (Jul 2008): 1203-9
IgA deficiency causes false-negative IgAbased celiac serology results in patients with celiac disease. Using a case-finding strategy, we examined the prevalence of IgA deficiency, physician evaluation, and management of IgA deficiency during serological testing for celiac disease. We reviewed consecutive IgA-endomysial antibody (EMA) and serum IgA results from the laboratory database over 17 months. We cross-referenced seronegative patients with IgA deficiency (IgA <0.06 g/L) to the pathology database to evaluate intestinal biopsy results. Ordering physicians received a questionnaire regarding the management of seronegative patients with IgA deficiency who had no biopsy record. Among the 9533 patients tested for IgA-EMA, 4698 (49%) were tested for IgA deficiency. IgA deficiency occurred in 35 of 4698 (0.75%) patients screened for IgA deficiency. Only 19 of 35 (54%) IgAdeficient patients were diagnosed appropriately with either intestinal biopsy (17 patients) or measurement of IgG-tissue transglutaminase (2 patients). Thirteen (76%) of the 17 IgA-deficient patients who underwent upper endoscopy with or without colonoscopy displayed gastrointestinal pathology on biopsies, including 3 (18%) with celiac disease. No further evaluation to exclude celiac disease was performed for the remaining 16 of 35 (46%) IgA-deficient, EMA-negative patients because of inappropriate management (6 patients), administrative error (7 patients), or patient/ physician refusal (3 patients). IgA deficiency occurred in 1:131 patients tested for celiac disease, and celiac disease occurred in 1:6 of those properly evaluated. Inadequate evaluation of IgA deficiency while testing for celiac disease occurred frequently and resulted in the underdiagnosis of both. Changes in testing algorithms and reporting of results were made to improve testing for celiac disease and IgA deficiency
Source: Proquest Nursing and Allied Health database

7. Celiac Disease: Are Endomysial Antibody Test Results Being Used Appropriately?
By McGowan, Kelly E; Lyon, Martha E; Loken, Steven D; Butzner, J Decker. Clinical Chemistry 53. 10 (Oct 2007): 1775-81
Patients display signs and symptoms involving a variety of organ systems, minor symptoms, or no apparent symptoms in conditions with an increased risk of celiac disease (4), Thus, serologic testing plays an increasingly critical role in the identification of patients with celiac disease. The early diagnosis of celiac disease is critical not only to resolve symptoms and improve quality of life (8, 9), but also to prevent long-term complications, including anemia, osteopenia, infertility, intestinal lymphoma, and perhaps other autoimmune diseases (10). Nonetheless, translating clinical guidelines into routine daily practice often does not occur (11), Given the difficulty in improving physician practice patterns, coupled with the general lack of awareness of celiac disease among clinicians (12) and the frequent reports of delayed and failed diagnoses (5,13-15), serologic testing for celiac disease may not be optimally used
Source: Proquest Nursing and Allied Health database

8. Narrative Review: Celiac Disease: Understanding a Complex Autoimmune Disorder
By Alaedini, Armin; Green, Peter H R.
Annals of Internal Medicine 142. 4 (Feb 15, 2005): 289-98
Celiac disease is a common autoimmune disorder that has genetic, environmental, and immunologic components. It is characterized by an immune response to ingested wheat gluten and related proteins of rye and barley that leads to inflammation, villous atrophy, and crypt hyperplasia in the intestine. The disease is closely associated with genes that code for human leukocyte antigens DQ2 and DQ8. Transglutaminase 2 appears to be an important component of the disease, both as a deamidating enzyme that can enhance the immunostimulatory effect of gluten and as a target autoantigen in the immune response. Sensitive and specific serologic tests, including those for anti-transglutaminase antibody, are facilitating fast and noninvasive screening for celiac disease. Thus, they are contributing to a more accurate estimate of the prevalence of the disease and its association with other disorders. Celiac disease is associated with increased rates of anemia, osteoporosis, cancer, neurologic deficits, and additional autoimmune disorders. A gluten-free diet is the mainstay of safe and effective treatment of celiac disease, although its effect on some of the extraintestinal manifestations of the disease remains to be determined.
Source: Proquest Nursing and Allied Health database

Journal - Table of Contents

9. From Nursing Times, Vol 108, no 22/23 - 29 May-11 June 2012
Interview: Dame Christine Beasley [Chief Nursing Officer for England]
Nursing Practice
. Research is on the right topics if combined with clinical role; patients' beliefs are key to drug concordance
Mental Health
. Using safety crosses for patient self-reflection [Patients in a medium-secure mental health unit used Productive Ward crosses as a tool for self-reflection in order to promote recovery]
. Preventing falls in patients with alcohol problems
9E. How effective are nurses' medicine discussions?
Professional Development
. Developing clinical research nurses

10. From Safeguard, March/April 2012, Issue 132
A just cause [Building and sustaining a 'just culture' is about getting the right balance]
10B. Safety culture research [Recent safety culture research by the Healthy Work Group]                     
10C. Bridging the gap [Victoria Middleton discusses her role as an occupational health nurse in improving safety culture during a major construction project]
10D. Why aren't we listening [Mark Taylor advises us to slow down and not jump to conclusions]
10E. Cast no shadow [UK consultant Dr Tim Marsh takes the concept of 'nudge' and explains how it is a key element of the 'mindful organisation']
10F. Keep the laughs rolling [Humour and repetition are useful tools to engage your staff in health and safety] 


11. HINZ 2012 Conference and Exhibition
Theme, Health Informatics into Clinical Practice, acknowledges how critical health informatics is and can be in everyday care. We are looking for your stories, your research and your leadership to make 2012 the Year of Health Informatics in New Zealand
Date: 7-9 November 2012
Venue: Energy Events Centre, Rotorua
Call for papers:

12. 8th Australasian Viral Hepatitis Conference
10th   to  12th September 2012
Venue:  Auckland, New Zealand

2 New Zealand Health Publications

13. Palliative Care National Joint Work Programme 2012
Publication date:
1 May 2012
This document has been jointly produced by Hospice New Zealand, the Ministry of Health and the Palliative Care Council.
It is intended to articulate the programmes of work that these organisations are undertaking on a national level and to explain how these will contribute to the achievement of specific outcomes
Download at this link:

14. Caring counts: Report of the Inquiry into the Aged Care Workforce
The Human Rights Commission’s report of the inquiry into the equal employment opportunity issues in the aged care workforce has been published. The inquiry team considered workforce issues raised by both employees and employers in the aged care sector when developing the report’s final recommendations.
“In my time as EEO Commissioner there has seldom been the degree of unanimity about a work-related issues than there is about the low pay of carers,” said Judy McGregor.
Download the full report at this link:

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