Emergency anaphylaxis protocols: A cross-sectional analysis of general practice surgeries and pharmacies in both the urban and rural setting in Ireland

Background: The incidence of anaphylaxis appears to be increasing worldwide with cases in the community outnumbering those in the hospital setting. General practice (GP) surgeries and pharmacies, based in the community, are often the first point of contact for many patients suffering from anaphylaxis.

Objectives: To determine if studied GP surgeries and pharmacies have an anaphylaxis protocol on site and have access to an anaphylaxis kit; to explore GP’s and pharmacists’ personal experiences with management of anaphylaxis.

Methods: A cross-sectional, questionnaire-based study was performed examining anaphylaxis protocols in a sample of general practices and pharmacies from some counties in Ireland. This consisted of a sample from rural and urban settings. The study commenced in October 2014.

Results: Nineteen of 24 GPs (79%) and 9 (29%) pharmacies had an anaphylaxis protocol (P?<?0.001). Twenty-four (100%) GP practices and 12 pharmacies (39%) surveyed had an anaphylaxis kit on site. Twelve GPs (50%) had treated a patient with anaphylaxis in the surgery while 8 (33%) had treated a patient in the community. One pharmacist (3%) had witnessed anaphylaxis in practice. Two pharmacies and one GP had been contacted by local businesses to alert them to a case of anaphylaxis.

Conclusion: In contrast to national and international guidelines only 79% of GPs and 29% of pharmacies in this study from Ireland had an anaphylaxis protocol onsite.     

The effect of time lapse on the accuracy of two acrylic resins used to assemble an implant framework for soldering

STATEMENT OF PROBLEM: There are insufficient data on the accuracy of resin indexing materials for the assembly of implant prostheses in vivo. MATERIAL AND METHODS: This in vitro study assessed the fit of an implant framework with the use of 2 common acrylic resins. PURPOSE: A standardized type IV gold alloy cast framework with 3 stainless steel implant replicas secured to 3 premachined gold cylinders placed 200 mm apart using a parallelometer was fabricated on a flat type IV stone model. Wax was placed around the center of each bar section, and a silicone matrix was fabricated to enable the same quantity of material to be used for each assembly. Each bar was sectioned at the center of the matrix, and indices (n=20) were fabricated from Duralay and GC Pattern acrylic resins. The materials were allowed to polymerize for 15 minutes before the assemblies were removed from the model. Frameworks were visually assessed for fit after an additional 15 minutes, after 2 hours, and after 24 hours, using the Sheffield 1-screw test. Observational outcomes are presented indicating visually perceived fit relative to the type of indexing resin. RESULTS: Both indexing materials were judged to be visually accurate at the 15-minute time interval only. CONCLUSION: Within the limitations of this in vitro study, both resin-indexed implant assemblies were judged visually accurate for fit 15 minutes after polymerization but not at subsequent test intervals.     

How reality orientation may impact upon violence and aggression within acute psychiatric care

The focus of this article is on how the technique of Reality Orientation (RO) may impact upon the phenomenon of violence and aggression within an acute psychiatric care environment. Within the text the term violence is used to represent both violence and aggression. Findings relating to how RO is associated with clinical violence in acute psychiatry care came to the fore after the author carried out a research study examining nurses perceptions of RO as practiced within an acute psychiatric and care of the elderly clinical environments. It is clear that RO interacts with the phenomenon of violence in acute psychiatry. It is also clear that psychiatric nurses require a greater understanding of the technique if it is to be implemented with greater efficacy within acute psychiatric care.     

Attribution bias underlying burns-induced anxiety symptoms

Introduction

Burn injuries are a debilitating cause of morbidity and mortality associated with the long-term impact of psychological factors on quality of life. Accurate assessment of the differential impact of burn sequelae and anxiety is often complicated by the overlap between psychological and somatic symptoms in burns patients. The Beck Anxiety Inventory (BAI) is one validated psychometric tool for anxiety assessment. The primary objective of this study is to investigate whether utilising the BAI as a tool to assess for anxiety in burns patients is biased due to the confounding of symptoms of anxiety with the physical sequelae of a burn injury.