Reducing the incidence of coronary heart disease

The incidence of coronary heart disease (CHD) has been significantly reduced by the introduction of the National Service Framework in 2000 but has not yet reached set targets. This article analyses the adverse effects of specific CHD risk factors to the cardiovascular system and proposes local and national strategies for further reduction in the incidence, morbidity and mortality of CHD. It provides an example of how nurses can use a health promotion programme to support patients in giving up smoking, a major contributing factor in CHD. The programme uses cognitive behaviour therapy to improve patients' uptake and adherence.

Barriers to effective pain management in sickle cell disease

Sickle cell disease (SCD) is a long-term condition that would benefit from a long-term conditions approach to its care and management. SCD is growing in prevalence, affecting 10,000-12,000 people in the UK, with SCD sufferers having an increased life expectancy from in the past. The most problematic aspect of managing SCD is management of the pain from vaso-occlusive crises. Vaso-occlusive pain is the most common reason for hospital admissions in people with SCD and accounts for large numbers of accident and emergency (A&E) attendances. A literature review was carried out to examine the management of vaso-occlusive pain in SCD. The review identified three main barriers to effective pain management in SCD: the manifestation of vaso-occlusive pain, the sociocultural factors affecting pain assessment, and the concerns regarding addiction and pseudo-addiction. Addressing these barriers will allow people with SCD to have their pain managed more effectively, improve their quality of life and potentially reduce A&E attendances and admissions to hospital.

Antioxidant principles of Tanacetum vulgare L. aerial parts

The methanolic extract of aerial parts of Tanacetum vulgare L. (Asteraceae) and its fractions were investigated for antioxidant activity. The crude extract displayed DPPH radical scavenging effects with an EC50 value of 37 +/- 1.2 microg/mL (n=3). Activity-guided fractionations of the crude extract resulted in the isolation of three antioxidant compounds; 3,5-O-dicaffeoylquinic acid (3,5-DCQA), axillarin and luteolin. 3,5-DCQA was the major constituent with antioxidant activity (IC50 = 9.7 microM) comparable with that of the standard quercetin (IC50 = 8.8 microM). Though the isolated compounds were previously known for their antioxidant effects, this is the first report on the identification of 3,5-DCQA from Tanacetum vulgare. The displayed potent antioxidant activity of the crude extract and isolated active principles is in support of the traditional medicinal uses of the plant for disease conditions such as wound healing, rheumatic arthritis and other inflammatory conditions.