Influences on use of hand moisturizers in nurses.

Background: Nurses are at high risk of hand dermatitis. Regular hand moisturizing can prevent dermatitis, but nurses' use of hand moisturizers is suboptimal. Aims: To establish (i) what beliefs about hand dermatitis and hand moisturizer use are associated with hand moisturizer use by nurses at home and at work and (ii) if hand moisturizer use behaviours in nurses are associated with the prevalence of hand dermatitis. Methods: We used a questionnaire to investigate nurses' knowledge, beliefs and behaviours regarding hand dermatitis and use of hand moisturizers. Results: The response rate was 55/65 (85%). Forty-two (76%) participants agreed that applying hand moisturizers reduced the risk of dermatitis, and 53 (96%) agreed that dermatitis increased the risk of skin carrying pathogenic organisms. Frequent moisturizer application was associated with beliefs that it was part of the nurse's role to apply hand creams, a belief that they had had training in the use of moisturizers and believing that patients approved of them moisturizing their hands. Conclusions: Hand moisturizer use by nurses can be improved by enhancing their beliefs that it is part of their professional role to apply hand cream regularly.

Delivery of cognitive behavioural therapy to workers: a systematic review.

BACKGROUND: Cognitive behavioural therapy (CBT) is a key intervention, enabling workers on sick leave with common mental health problems to return to work. It can be delivered by a variety of methods including face-to-face therapy and the Internet. It is not known which is the optimal method of delivery. AIMS: To establish the optimum method of delivering CBT to workers with common mental health problems. METHODS: We undertook a systematic search of the OvidMEDLINE and EMBASE biomedical databases from the start of electronic records to 31 July 2013 for randomized trials comparing one method of delivering CBT with another for treatment of mild-to-moderate depression, anxiety and adjustment disorders. We included publications that assessed at least one of four outcomes: clinical or cost-effectiveness, accessibility and acceptability. A scoping search found no studies in the workplace. We therefore focussed on interventions in the 18-65 year age group. RESULTS: We found six studies comparing methods of delivery of CBT for anxiety disorders but found no trials which compared methods of delivery for mild-to-moderate depression. All delivery methods led to an improvement in anxiety symptoms. Internet-delivered CBT with some input from a therapist was found to be as clinically effective as face-to-face CBT and more cost-effective. CONCLUSIONS: Internet CBT should be made available in workplaces for workers with anxiety disorders as part of a stepped care plan.

Radiation-associated choroidal neovasculopathy.

PURPOSE: To characterize a newly discovered choroidal vascular abnormality in patients who have received radiation therapy for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration. DESIGN: Two-center cross-sectional study. PARTICIPANTS: In the United States, there were 95 patients who were treated with 10 or 12 Gy of external beam photons. In Belgium, 98 patients were treated with 20 Gy. These patients were examined retrospectively for the presence of a specific CNV abnormality. RESULTS: During the follow-up period, an unusual vascular growth pattern was identified in 12 patients (12.6%) of those treated in the United States and in 7 (7.1%) of those treated in Belgium. These patients developed round or oval vascular blebs along the outer border of their neovascular lesions. These blebs profusely leaked fluorescein dye and could be imaged best by indocyanine green angiography. Patients with these blebs appeared to have a marked propensity for loss of visual acuity. CONCLUSION: An unusual pattern of new vessel growth occurred in 19 of the 193 patients with CNV treated with radiation. This new entity, termed radiation-associated choroidal neovasculopathy, is a recognizable disorder that appears to have a particularly poor prognosis.

Arteriolar vasoconstriction in rat cremaster muscle induced by local heat stress.

The effect of moderate local heat stress on arteriolar tone in the cremaster muscle of anesthetized rats was investigated by direct microscopic observation. Muscle temperature was raised from the in vivo temperature of 34.5 to 38 degrees C, over a 5-min period, by elevating bath temperature. Muscle temperature, arteriolar lumen diameter, and arteriolar red blood cell velocity were continuously recorded. A number of the smallest arterioles studied (approximately 30 micrometers lumen diam) underwent a rapid and significant vasoconstriction near 36 degrees C. Denervation of the muscle eliminated the constrictor response. Addition of an alpha-blocking agent (dibenzyline to the denervated muscle unmasked the constriction, but the percent of arterioles demonstrating thermal reactivity remained decreased. We conclude that in some skeletal muscle beds a local thermoregulatory mechanism may exist whereby blood is shunted away from the tissue during heat stress at rest.