Stroke is a major cause of mortality and lifelong disability, despite advances in diagnosis and treatment. The risk factors of stroke are well-known and many are modifiable through lifestyle adjustments, however, the incidence of first-time stroke is increasing year-on-year. Primary stroke prevention is an important health promotion issue and successful implementation could lead to a reduction in the incidence of stroke and relieve a costly burden to the NHS. Nurses play an important role in providing information and advice to patients in secondary prevention of stroke, and could play an equal role in primary prevention. Providing advice on lifestyle behaviours such as smoking, alcohol consumption, diet and exercise all fall under the remit of the nurse in health promotion and in secondary stroke care. By providing a primary prevention service, community nurses could work as case managers for a larger multidisciplinary team and provide prevention advice and treatment.
Steve Robertson, professor of men, gender and health and co-director of the Centre for Men’s Health at Leeds Beckett University
A six-week community wellness programme was conducted to promote weight loss and reduce obesity. Participants’ weight, blood pressure, waist circumference, body mass index, and finger-stick glucose were measured before and after the programme which included exercise, nutrition and diabetes prevention sessions. Initially, 189 men and women enrolled; 74 participants were included in the post-intervention data collection. Statistically significant results (p <0.001) indicated that women reduced weight (mean 3.31% ± 0.02%) and decreased waist circumference by 1.91552% ± 2.14454 inches. Men reduced weight significantly (mean 6.5% ± 0.44%) and decreased waist circumference (mean 3.14063 ± 3.04118 inches) (p<.001).
Jenny Manry, DNP, FNP, APRN-BC, Assistant Professor, Fort Hays State University
Jane Peterson, PhD, APRN, FAANP, Clinical Associate Professor, University of Missouri Kansas City
Article accepted for publication: February 2013
This articles deals with the dietary advice that should be provided to people with type 2 diabetes by anyone working in the community (it does not cover advice on physical activity or prevention of type 2 diabetes). If a patient with type 2 diabetes is overweight or obese, the most important factor is to lose weight — even a 5–10% weight loss can improve insulin sensitivity and hence diabetic control. Other factors that are considered in this article are the type of carbohydrate that can be eaten, with wholegrain/high-fibre, lower glycaemic index starches being the best option (the glycaemic index measures the effect of carbohydrates on blood glucose level). Although sugar provides 'empty calories' (food that supplies energy but negligible nutrition) and can result in weight gain, it does not contribute to diabetes directly. Cholesterol levels should be reduced by eating the correct fats, and salt levels should be kept to below 6g a day.
This articles looks at the dietary advice that should be provided for people with type 1 diabetes. As well as focusing on healthy eating generally, blood sugar control can be optimised if both the type and amount of carbohydrate is considered. Low glycaemic index (GI) carbohydrates, where glucose is released slowly into the blood stream, may help to lower the individual’s glycated haemoglobin (HbA1c) levels (HbA1c is a form of haemoglobin that is measured to identify the average plasma glucose concentration over a prolonged time period). Carbohydrate (‘carb’) counting should be considered as it can improve glycaemic control and promote independence in regard to food choice and management of the condition. Gestational diabetes (that which develops during pregnancy) is also considered, as this can affect birth outcome, the baby’s future health and the health of the mother after the birth.
In each issue we investigate a hot topic currently affecting you and your community practice. Here, Georgia Craig looks at alternative ways to review patients in the community and asks... Restoring joy to practice: could group consultations help?
The Colostomy Association is a national charity that provides support, reassurance and practical advice to anyone in the UK who has, or is about to have, a colostomy. We are here to help and support patients, their families and carers. Our helpline is manned 24 hours a day by volunteers who all have a stoma. Our wide range of leaflets, quarterly magazine Tidings and closed Facebook group offer information and support to anyone affected by life-changing stoma surgery.
Far from seeking attention for their own work, many nurses actually shy away from the media. Here, Mariama Barrie explains how she used publishing to spread the word — and why you should be doing the same...
The team of Eczema Outreach Scotland (EOS) has been working with families dealing with the day-to-day struggle of childhood eczema for over five years. Magali Redding, a West Lothian mother of three and voluntary sector professional, set up the group when her daughter asked tearfully: ‘why am I the only scratchy girl in the world?’ In between their precious clinic appointments, the family had been feeling increasingly frustrated and isolated in their battle with the impact of eczema on life.
