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Healthcare policies promote technology use as a means to modernise healthcare and support seamless, person-centred care. However, despite information technology (IT) use being common practice in clinical settings, its use in patients' homes is still developing. This study explored patients' perspectives on the use of IT and electronic health records (EHR) in their home environment. Semi structured interviews were conducted with housebound patients who received regular care from the district nursing team, and thematic data analysis was undertaken. Participants reported variable knowledge and experiences with mobile working and EHR. Most were positive and identified clear benefits for clinicians. However, few participants reported benefits to themselves. Contrary to popular belief, IT use is expected by older patients and, while barriers were identified, the overall opinion was positive. A digital divide was apparent, with some at risk of being disadvantaged by the increasing use of technology. [ABSTRACT FROM AUTHOR]

Low vitamin B12 has been associated with raised plasma homocysteines and the consumption of B vitamins has been shown to reduce homocysteines. Raised levels of homocysteines have been linked to causing symptoms of mental illness. B12 is also required in the synthesis of monoamines and is required to maintain neurological health. Aim: This study reviews research into the effects of the supplementation of B12 in the prevention and recovery of mental illness, and the potentiation of psychotropic medication. Methodology: This literature review follows a systematic approach to searching databases CINAHL, EMBASE, Medline, and PsycINFO where 287 non-duplicated articles results were received. Appropriate articles were identified through title and abstract screening and inclusion and exclusion criteria were applied. Five articles were chosen to address the research question following critical appraisal. Thematic analysis was then conducted. Findings: This review identified five randomised controlled trials into the supplementation of various doses of B12 in conjunction with folic acid and B6. The supplement was measured against post-stroke depression prevention, the reduction of symptoms of depression in woman with cardiovascular disease, the effect on negative symptoms in schizophrenia, the reduction and prevention of depression in older adults, and the potentiation of psychotropic interventions. The papers reviewed showed inconclusive results, but evidence to support sub-groups and specific high-risk groups. Strong evidence showed supplementation of B12, folic acid and B6 has high rates of preventing post-stroke depression. Conclusion: The findings show that this area of research is still to be developed. The effects of B12 supplementation with other B vitamins on mental health have shown to be inconclusive. There is a case for its use to be considered within certain patient groups to aid recovery of mental health or in some high-risk patient groups. Recommendations are made for further research into high-risk groups of people that may have symptoms or symptoms that could be improved through the supplementation of B12. [ABSTRACT FROM AUTHOR]

In modern society, people engage in social interactions and activities outside their own home. When in public settings people may need to eliminate bodily waste, so public toilets are required. Accessibility, availability and adaptability are essential principles for safe, private, and purposeful visits to public toilets. A diverse range of individuals use public toilets: various age profiles, all gender groups, vulnerable individuals and people with additional needs. Public toilets essentially need to be a place of privacy, safety and cleanliness to facilitate elimination of urine, evacuation of faeces, management of menstruation, and changing/disposing of continence wear products in a secure environment. [ABSTRACT FROM AUTHOR]

Dementia and incontinence are both prevalent in older age; yet, neither are an inevitable or normal part of ageing. It has been recognised that there is a skills and knowledge gap in professionals assessing and managing incontinence for people living with dementia. All too often, assumptions are made that incontinence is a symptom of dementia and that nothing can be done if a person living with dementia experiences episodes of incontinence. While dementia may impact on a person's ability to remain continent, it may not be the sole cause, and there may be treatments and strategies that can reduce the incidence in those affected. Therefore, a person-centred continence assessment should be undertaken to promote continence and reduce the impact of incontinence for people living with dementia and those who care for them. This paper will highlight some of the issues that are important for health and social care professionals to explore and identify, assess and manage incontinence to improve outcomes for families affected by dementia. [ABSTRACT FROM AUTHOR]

Deborah Robertson provides an overview of recently published articles that may be of interest to non-medical prescribers. Should you wish to look at any of the papers in more detail, a full reference is provided [ABSTRACT FROM AUTHOR]

Dementia is an umbrella term used to describe a group of symptoms characterised by behavioural changes, loss of cognitive and social functioning brought about by progressive neurological disorders. There are estimated to be 944 000 people living with dementia in the UK and it is indicated that this will increase to 2 million by 2051. We are learning more about the risk factors for developing dementia over the life course. This paper discusses the modifiable and non-modifiable risk factors for dementia and considers health promotion and health education activities that can be used in a primary care setting. [ABSTRACT FROM AUTHOR]

In this section, Nikki Welyczko presents a brief synopsis of a range of recently published articles that may be of interest to nurses working in the renal setting. The aim of this roundup is to provide an overview, rather than a detailed summary and critique, of the research papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of skin lesions and evaluate the clinical and sociodemographic factors associated with their presence in hospitalised patients. Method: This descriptive, cross-sectional, correlational study was performed in inpatient units and intensive care units of a cancer hospital in São Paulo, Brazil, after approval by the Institutional Research Ethics Committee. Data from hospitalised adult patients with cancer were collected during physical examinations and from medical records. A Chi-squared test, univariate analysis, a logistic regression model with results expressed as odds ratio (OR) and 95% confidence intervals (CI), and Classification and Regression Tree (CART) analysis were used to evaluate the data. Results: Of 341 patients, 80 had skin lesions, equating to an overall prevalence of 23.5%. The skin lesions included pressure injuries (10%), incontinence-associated dermatitis (6.7%), skin tears (6.5%), malignant wounds (3.8%) and complicated surgical wounds (3.2%). The factors associated with skin lesions in cancer patients were the use of disposable nappies (OR: 4.436) and age (59.1±15.1 years), according to the CART analysis, and the wearing of nappies (OR: 4.466, p<0.001), presence of ecchymosis (OR: 2.532, p<0.001) and infection (OR: 6.449, p=0.040), according to multiple regression analysis. Conclusion: This study contributed to knowledge about prevalence and associated factors of skin lesions in hospitalised patients with cancer, allowing the implementation of preventive measures. [ABSTRACT FROM AUTHOR]

In community nursing, the administration of insulin for people with type 2 diabetes can be delegated by registered nurses to healthcare support workers. Although a voluntary framework in England provides national guidance, little is known about its uptake. The project aim was to determine the roll-out, characteristics and support needs in relation to the delegation of insulin administration in community settings. An online survey was disseminated to community nursing services in England via social media and nursing networks. Of the 115 responding organisations, 81% (n=93) had an insulin delegation programme, with most initiated since 2018. From these services, 41% (n=3704) of insulin injections were delegated daily, with benefits for patients, staff and services reported, along with some challenges. Delegation of insulin administration is an established and valued initiative. Awareness of the national voluntary framework is increasing. National guidance is considered important to support governance arrangements and safety. [ABSTRACT FROM AUTHOR]

As the population ages and so do the numbers of people with dementia, there will also be an increase in the number of unpaid family carers. Estimates suggest that one in three of us will become a carer for someone with dementia during our lifetime, some caring for more than one person diagnosed with dementia in their family. There are currently over 700 000 people in the UK acting as primary unpaid carers for people with dementia, all of whom make a substantial contribution, both financially and physically, to their care and support. Carers of people with dementia can experience high levels of carer burden and distress as well poor health and wellbeing due to their caring roles. However, they can sometimes be less than visible to health and social care services as they may not identify themselves as carers or their needs may not be easily recognised which leaves them at risk. Identifying people in caring roles and assessing their needs are the first two steps in supporting them. Community nurses are well placed to do this within their roles. [ABSTRACT FROM AUTHOR]

Background/Aims Antenatal care is important for screening, monitoring and management of pregnancy risks. This study analysed determinants of antenatal care in Indonesia among women aged 18-24 years and older than 30 years, who are at greater risk of pregnancy and birth complications. Methods This cross-sectional study used secondary data from 4338 women in the 2017 Indonesian demographic health survey. Chi-square tests and binary logistic regression were used to explore the effects of individual, partner and social factors on antenatal care. Results Antenatal care attendance was associated with a younger age at first birth (adjusted odds ratio: 1.49; P<0.001), health insurance (adjusted odds ratio: 1.54; P=0.004) and the middle wealth quintile (adjusted odds ratio: 1.78; P=0.002). Conclusions Collaboration is needed to increase awareness of complications and the importance of antenatal care. [ABSTRACT FROM AUTHOR]

Pressure ulcers are debilitating and often painful problem, particularly in people who are elderly, immobile and/or obese. It is estimated that more than 100 000 new pressure ulcers develop each year. These wounds are caused by friction and shear and are particularly prevalent in older people, where malnutrition can be a factor in their development. Nutrition plays a key role in pressure ulcer care because wounds need both macronutrients and micronutrients to heal. It is essential that nurses understand the role of nutrition in pressure ulcer management. [ABSTRACT FROM AUTHOR]

Background: Around 70% of women who give birth vaginally experience perineal injury during childbirth, which may happen spontaneously or as a result of the incision made to facilitate childbirth. There are very few studies on the perceptions of episiotomy recipients about these services. Therefore, investigating these women's perception is crucial for providing appropriate care. Methods: This qualitative study examined 20 women from hospitals and health centres who had undergone episiotomy using in-depth semi-structured interviews. Data were analysed using conventional content analysis and the accuracy and rigour of the data were assessed using the Lincoln and Guba criteria. Results: The 'change in perception and behaviour' theme encompassed one category of negative experiences and views about episiotomy and a second category covering positive views. Conclusions: Women's perceptions of episiotomy contained both positive and negative views. Since healthcare systems should support mothers' physical and mental health, it is recommended that health policymakers devise plans to boost factors that lead to positive views and eliminate those contributing to negative experiences and views. [ABSTRACT FROM AUTHOR]

Peristomal skin problems are common in ostomy patients and are connected to decreased quality of life and patient independence, as well as increased treatment costs. This study analysed the factors related to peristomal skin changes in order to better define the clinical profile of patients with optimal peristomal skin status. Secondary analysis of data from a nationwide, cross-sectional, retrospective, multicentre study performed in Spain (Uses and Attitudes in Ostomy) (Bueno Cruz et al, 2021) evaluated clinical data, including demographics, preoperative stoma site marking, type of ostomy, device used, frequency of leakage and scores from the Ostomy Skin Tool (OST) and quality of life (QoL) questionnaires. Risk factors for peristomal skin changes were analysed using multivariate analysis, and a predictive nomogram to anticipate optimal peristomal skin status (defined here as discolouration (D), erosion (E), and tissue overgrowth (T) (DET) score of 0) was developed. Some 871 patients with an ostomy using different commercial devices in Spain were evaluated. Multivariate analysis to predict optimal peristomal skin status revealed leakage frequency, patient age, type of ostomy, preoperative siting and type of baseplate used were independent predictors of peristomal skin status. Optimal peristomal skin care should be a treatment goal for nurse specialists in stomal therapy, and its individual influencing variables should be taken into account by nurses specialising in ostomy care. [ABSTRACT FROM AUTHOR]

This article outlines a study to determine the cost effectiveness of population-wide screening for chronic kidney disease. This study found that screening a population between the ages of 35 and 75 had the potential to prevent the need for kidney replacement therapy in 398 000 Americans. [ABSTRACT FROM AUTHOR]