Resources

Oral disease can significantly impact systemic health, and vice versa. This article highlights the potential mechanisms of how gum disease (periodontitis) and root canal infection may exacerbate various chronic illnesses, such as cardiovascular disease, diabetes and dementia. The bi-directional relationship is discussed whereby immune-compromised patients may experience poor healing after dental treatment. As many oral diseases are preventable, oral healthcare professionals can play a vital role in improving awareness and educating patients on the association between good oral health and their general health. Greater interdisciplinary collaboration is key to improving patient care.

Abnormal bleeding of any type is a cause of concern for women affected and is a frequent presentation in primary care. This is the second piece in a two-part series, the first part discussed amenorrhoea and oligomenorrhoea, while this article looks at dysmenorrhoea and menorrhagia. It gives an overview of signs and symptoms, risk factors, treatment and complications, with the purpose of giving nurses and non-medical prescribers more confidence in advising women who approach them for advice, so that earlier diagnosis and treatment can be possible to improve outcomes and quality of life.

Diagnostic spirometry is key to supporting a clinical diagnosis of lung impairment. As a result of Covid-19, spirometry services in primary care were all but cancelled. There was much debate about the potential risks associated with spirometry as a potential aerosol generated procedure (AGP); clarity was needed for patients and staff. The evidence is now clearer, spirometry is not an AGP, although spirometry-associated cough has the potential to release airborne particles in the air, associated with an increased risk of transmission of harmful viruses such as Covid, influenza and the common cold. This article explores recent evidence to support the safe re-introduction of quality-assured spirometry in primary care, looking at how risks can be mitigated to try to readdress the backlog of diagnostic spirometry thought to be in the region of 200–250 patents per 500,00 population. Spirometry is important to reduce health inequalities for patients yet to have a diagnosis of lung disease.

The measles vaccine represents a monumental achievement in modern medicine, effectively curtailing childhood mortality and morbidity on a global scale. However, recent trends in measles vaccine uptake present a concerning scenario, with declining rates posing a threat to the progress achieved in eradicating this highly contagious disease. This article delves into the pivotal role of the measles vaccine in safeguarding child health, exploring the reasons underlying vaccine hesitancy, including the controversial Lancet article, and discusses the additional impact of the Covid-19 pandemic on vaccine adoption. Drawing on global data from the World Health Organization (WHO) and Global Alliance for Vaccine and Immunisation (GAVI), this piece also assesses the consequences of dwindling measles, mumps, rubella (MMR) vaccine coverage on community well-being and offers strategies to combat vaccine hesitancy.

Shingles infection remains a risk in the UK for those who are immunocompetent or immunocompromised. One in five people in the UK will contract shingles in their lifetime and the risks of a more severe illness and longer term sequelae increase with age (NHS England, 2023). Uptake of the vaccine has been generally poor since it was first introduced in 2013–2014 (UK Health Security Agency [UKHSA], 2023a). Reasons for this may include an opinion that shingles is not severe, or a lack of information that a free vaccine is available, as well as poor accessibility and myths around the vaccine (Bricout et al, 2019). The change in the national immunisation programme for shingles from 1st September this year, with a more structured addition of additional groups up until 2030 and a good selection of vaccines and manageable intervals will hopefully help with this (UK Health Security Agency [UKHSA], 2023a).

An awareness of the impact of climate change has led to policies to reduce greenhouse gas emissions (GHGEs). The National Health Service (NHS) is the UK public sector’s largest emitter of greenhouse gases, with a target to deliver a net zero NHS by 2050 (NHS, 2020). Pressurised metered dose inhalers (pMDIs), which use hydrofluoroalkanes (HFA) as the propellant, have been targeted as a perceived easy option to reduce the NHS carbon footprint of HFA, as alternative inhaler devices in the form of dry powder inhalers (DPIs) and soft mist inhalers (SMIs) which contain no propellant are readily available. Balancing the environmental impact while ensuring that the best option of inhaler device is provided for individual patients can lead to conflict and confusion for healthcare professionals while waiting for manufacturers to provide pMDI with propellants that are more environmentally friendly. This article discusses sustainability, from manufacture to disposal.

Clinical placements play a crucial role in the education of pre-registration nursing students, enabling them to gain practical experience and exposure to diverse clinical settings. This article explores the development and pilot of the Leeds primary care student leadership placement, a novel approach to address the challenges posed by limited general practice nursing clinical placement opportunities. The placement, developed and implemented as part of the Queen’s Nursing Institute (QNI) Community Nursing Innovation Programme 2022–2023, provided four final-year adult nursing students with access to a general practice placement spanning a primary care network (PCN). Under a structured programme of support, these students led on NHS health check clinics across multiple sites. The project’s findings indicate that the placement resulted in increased knowledge and understanding of the general practice nursing role, preventative healthcare, health needs and health inequalities, digital health, inclusion and leadership skills and attributes. Moreover, the concept raised awareness of career pathways available in general practice among new registrants and established a sustainable practice learning model, which is adaptable to all healthcare settings. This demonstrates the value and potential of innovative clinical placement approaches in nursing education.

Heart failure (HF) remains one of the most common reasons for hospital admissions and is predicted to rise substantially in the next decade. As many of these patients have other comorbidities, general practice nurses (GPNs) are in the ideal position to assess and identify any possible deterioration before it results in admission. Having a good understanding of HF, terminology and treatment will assist with this, and standardising care and reviews in line with current guidelines will improve care.

Here, Callum Metcalfe-O’Shea, advanced nurse practitioner diabetes specialist and co-chair for the Norfolk Health Professionals Diabetes Forum, provides the last part in the diabetes digest series with an outlook on the future of care provision for diabetes in primary care settings. This article explores the current data on diabetes, acknowledging the change in future therapies and the role of diabetes technology in advancing care. The role of the GPN is also examined to highlight the need to recognise their involvement in supporting high quality care.

Stressors in life often seem to have a habit of coming all in one go. Before the summer holidays I felt tired out emotionally and physically and that I was being bombarded with a constant stream of issues at home and at work to problem solve and manage. No sooner was one issue sorted and another two swept in to take its place. I like to be busy and enjoy a challenge, but I felt over stimulated and exhausted. At the same time a rather negative voice had set up shop in my head, I was not making enough time to look after myself and was looking with envy at my university friend posting pictures of her sunny lunch dates now she has taken early retirement.