Evid Based Nurs doi:10.1136/eb-2013-101633
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    1. Correspondence to: Helen Noble
      Queens University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK; helen.noble{at}

    Drug and Therapeutics Bulletin (DTB) April, May, June 2013 issues

    HbA1c targets in type 2 diabetes: guidelines and evidence

    • Aims of treatment for type-2 diabetes include minimising long-term complications (eg, cardiovascular disease, blindness, chronic kidney disease, premature mortality) and avoiding the unwanted effects of treatment (eg, severe hypoglycaemia, weight gain).

    • Publication of the UK Prospective Diabetes Study (UKPDS) 33 in 1998 suggested that ‘intensive blood glucose control’ to lower the glycated haemoglobin (HbA1c) in people with type 2 diabetes reduced microvascular disease but not macrovascular complications.

    • The UKPDS 34 study in overweight patients found that metformin produced less of a reduction in HbA1c but reduced cardiovascular complications and death. Recently, further trials have examined the impact of intensive glycaemic control and have produced conflicting results.

    • In this article we examine the evidence and guideline recommendations for HbA1c targets; glycaemic control for acutely unwell patients and targets in pregnancy will not be covered (DTB;51:42–5).

    What place for racecadotril?

    In this article, we review the evidence for racecadotril and its place in the management of acute diarrhoea (DTB 2013;51:54–7).

    Glycopyrronium for COPD

    In this article, we review the evidence for glycopyrronium and assess its place in the management of chronic obstructive pulmonary disease (DTB 2013;51:66–8).

    Prevention of recurrent urinary tract infections in women

    • Recurrent urinary tract infections (UTIs; usually defined as three episodes in the last 12 months or two episodes in the last 6 months) can have a considerable impact on a woman’s quality of life.

    • Each episode of acute UTI in young women is typically associated with about 6 days of symptoms, 2.4 days of restricted activities and 0.4 days of bed rest.

    • Antibacterial prophylaxis is effective in preventing recurrent episodes, but at the expense of unwanted effects and a risk of promoting bacterial resistance. In this article, we assess the efficacy of different antibacterial regimens and non-antibacterial alternatives (cranberry, probiotics, oestrogens, immunostimulation, hyaluronic acid and chondroitin, acupuncture and herbs) in the prevention of recurrent uncomplicated UTIs in women (DTB 2013; 51:69–74).

    Cochrane reviews relevant to nursing care

    The Cochrane Nursing Care Field has continued its work in tagging Cochrane Systematic Reviews in the Cochrane Library that are relevant to those involved in nursing care. They are organised by specialty and their primary fundamental of care.

    Royal College of Nursing: e-learning/online learning resources

    RCN learning zone (UK)

    • The Learning Zone offers you interactive learning and resources to support your research and professional development activities.

    • The learning zone is not just a ‘repository of resources’ but a much more dynamic service designed to help members use information to improve patient care.

    • Take a look at Clinical Guideline Development’ in the Clinical Skills section or explore the learning opportunities in the Personal Skills Area within the ‘Skills for Active Learning’ section such as ‘Intute versus Google’.

    Learning Nurse—Medical Information Podcasts

    Offers a selection of free podcasts covering topics such as: antibiotics use, arthritis, asthma, cervical cancer and colorectal cancer.

    Clinical evidence

    Clinical evidence comprises an international database of high-quality, rigorously developed systematic overviews assessing the benefits and harms of treatments, and a suite of EBM resources and training materials.

    National Institute of Health and Care Excellence

    Faecal calprotectin diagnostic tests for inflammatory diseases of the bowel (DG11)
    Diagnostics guidance, DG11—Issued: October 2013

    • Faecal calprotectin testing is recommended by National Institute of Health and Care Excellence (NICE) as an option to help doctors distinguish between inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis and non-inflammatory bowel diseases, such as irritable bowel syndrome.

    • Many people with irritable bowel syndrome have unnecessary invasive hospital investigations before their condition is diagnosed.

    • Using faecal calprotectin testing will mean most people with irritable bowel syndrome will be diagnosed without the need for these investigations.

    Depression in children and young people (QS48)
    Quality Standards, QS48—Issued: September 2013

    • Depression is most often not confined to only one family member.

    • Parental depression is a strong risk factor for the child or young person’s depression, and the child or young person’s experience of depression is best helped by their parents or carers.

    • Parents and carers have an important role to play in supporting the child or young person with depression and should be engaged at all stages of assessment, diagnosis and treatment.

    Sands, the stillbirth and neonatal death charity

    Sands, the stillbirth and neonatal death charity, has launched a new website following research which showed almost half of its visitors were accessing information from mobile phones or tablets. The charity, which was set up more than 30 years ago, provides anyone visiting the website with the best possible service. The new site provides an optimal viewing experience for users, meaning it is easy to read and navigate from any device, including mobile phones, tablets, laptops and desktops. Sands has made all of its support literature downloadable for free.

    UK Clinical Research Network Training

    • As part of the National Institute for Health Research, this site helps to provide the infrastructure that allows high-quality clinical research to take place in the National Health Services (NHS), so that patients can benefit from new and better treatments and healthcare professionals can learn how to improve NHS healthcare for the future.

    • On this site you can find out how we are: helping researchers to set up clinical studies quickly and effectively; supporting the life-sciences industry to deliver their research programmes; providing healthcare professionals with research training; and working with patients to ensure their needs are at the very centre of all research activity.

    The Knowledge Network

    The Knowledge Network provides evidence, information, e-learning and community tools. It supports all staff to find, share and use knowledge in day-to-day work and learning.

    • What will you find here?

    • e-Learning resources

    • Tools to help you create and share e-learning content

    • IT and information skills development opportunities

    • Help with developing your career

    • Some principles and processes on which effective education is founded; including learning styles and educational theory.

    Public Health Online Resources for Careers, Skills and Training

    • The Public Health Online Resource for Careers, Skills and Training (PHORCaST) website has been created to help recruit, retain and develop the careers of people working in public health (including health and well-being) at all levels and working in all sectors.

    • It provides people and organisations with a wide-ranging source of information about roles and careers in public health and it provides advice about how to assess your current position and how you might develop your skills and knowledge through education and training. PHORCaST is for you if you are interested in health and well-being issues.

    • You will find useful information here if your current role only has a public health element or if you have a specific public health role, at any level (from volunteers to senior management) and in any sector (the NHS, in local government or in the independent sector).

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