Recommended elearning resource: The Open Dementia Programme

Created in 2009, the Open Dementia e-Learning Programme is for anyone who comes into contact with someone with dementia and provides a general introduction to the disease and the experience of living with dementia. This programme is suitable for a wide audience and to make learning as enjoyable as possible and so allows users to fully interact with the content and includes video, audio and graphics to make the content come alive. In particular the programme includes a considerable amount of new video footage shot by both the Alzheimer’s Society and SCIE where people with dementia and their carers share their views and feelings on camera.

Sections include:

  • What it is and what it isn’t
  • Living with dementia
  • What causes dementia
  • Diagnosis and who can help
  • Common difficulties and how to help
  • The emotional impact
  • Positive communication

PLUS there is a wealth of useful information available at The Dementia Gateway

NHS Evidence resources: Bone Cancer Research Trust

NHS Evidence logoExtract from NHS Evidence: Sept 2011

Users of NHS Evidence can now gain access to patient information from the Bone Cancer Research Trust (BCRT), a national organisation which aims to improve outcomes for people with primary bone cancer through research, awareness, information and support. 

BCRT has produced information guides on two bone cancers, osteosarcoma and Ewing’s sarcoma. The comprehensive guides include overviews of the conditions, causes, symptoms, survival rates and diagnosis techniques.

All of BCRT’s information is reviewed annually to ensure it is still current and accurate. The organisation monitors scientific and medical literature and revises and amends information immediately if there are changes in national guidelines, treatments or other significant changes in evidence.

All patient information available through NHS Evidence has been accredited under the Department of Health’s Information Standard.

Aspirin and cardiovascular disease

Full text extract from NHS Evidence:  Sept 2011

Overview: Aspirin is one of the most used medicines. It has long been a major analgesic and antipyretic, and now is widely used in lower doses as an antiplatelet agent helping to  reduce heart disease and strokes.

Research has shown aspirin to be effective in decreasing cardiovascular morbidity and mortality in patients with clinical evidence of cardiovascular disease (BMJ Clin Res ed. 2002 Jan 12;324(7329):71-86 and  Berger JS et al, Am J Med. 2008 Jan;121(1):43-9). However, there is ongoing debate about the role of aspirin in the prevention of cardiovascular disease for people without the condition. 

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Chemotherapy duration for advanced breast cancer

Cancer ribbon emblemExtract from NHS Evidence: Sept 2011

Overview: Breast cancer is the most common cancer affecting women in Englandand Wales, with about 40,500 new cases diagnosed and 10,900 deaths recorded in Englandand Wales each year.  In men breast cancer is rare, with about 260 cases diagnosed and 68 deaths in England and Wales each year.

Of these new cases in women and men, a small proportion are diagnosed in the advanced stages, when the tumour has spread significantly within the breast or to other organs of the body. In addition, there are a significant number of women who have been previously treated with curative intent who subsequently develop either a local recurrence or metastases.

Current treatment: There is currently no cure for advanced breast cancer. However, treatment can slow tumour growth, relieve symptoms and improve quality of life.

NICE recommends endocrine therapy as first line treatment for the majority of patients with oestrogen receptor-positive advanced breast cancer. Chemotherapy is an option for patients who are not responding to hormone therapy or whose breast cancer is hormone receptor negative.

The NICE Pathway: breast cancer, brings together all related NICE guidance and associated products on the condition in a set of interactive topic-based diagrams.

New evidence: A systematic review and meta-analysis of randomised controlled trials (Gennari et al: Clin Oncol. 2011 Jun 1;29(16):2144-9) evaluated the effect of different first-line chemotherapy durations in patients with advanced breast cancer on overall survival and progression free survival.

The results of trials including 2,269 patients found that longer first-line chemotherapy duration significantly improved both overall and progression free survival.
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Non-invasive ventilation for acute pulmonary oedema

Extract in full from NHS Evidence: Sept 2011

Overview: Pulmonary oedema occurs when fluid leaks from the pulmonary capillary network into the lung interstitium and alveoli. It is frequently caused by disease affecting the heart’s left ventricle and may complicate the presentation of acute heart failure. The condition is a common medical emergency which requires urgent intensive treatment to reduce the risk of mortality.

Current treatment: Treatment of acute pulmonary oedema (ACPO) should be directed at reversing the specific cause, although this is not always possible.

Management is otherwise supportive and directed at improving oxygenation, perfusion and haemodynamics, and preventing further cardiac and/or renal damage.

Emergency treatment of acute heart failure includes morphine, nitrates, oxygen, diuretics and non-invasive ventilation (NIV), with urgent angiography if acute coronary syndrome is thought to be the cause. 
New evidence: A randomised controlled trial, carried out across 26 UK hospitals, set out to measure health utility and survival in patients with acute cardiogenic pulmonary oedema, identify predictors of outcome and determine the effect of initial treatment with NIV on outcomes (Goodacre, S et al. Emerg Med J 2011 28: 477-482).
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Global rise in diabetes

Extract from NHS Evidence: Issue 29 September 2011
Overview:  Diabetes is the most common endocrine disease affecting more than one million people in the UK and causing three million deaths globally each year. It  is defined by high blood glucose: fasting plasma glucose (FPG) below 5.6 millimoles per litre (mmol/L) is considered normal, above 7 mmol/L is diagnostic of diabetes and an FPG level between 5.6 and 7 is considered pre-diabetes.

Treating diabetes accounts for approximately 10% of NHS spend. This is largely due to its associated complications which include coronary, cerebrovascular, ophthalmological and renal disease.

New evidence: A global study into diabetes prevalence (Danaei, G et al, The Lancet, 378, (9785) 31-40) shows the number of cases has more than doubled over the past 3 decades, with an estimated 347 million people now living with the condition worldwide.

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