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Community psychologists have a long-standing interest in promoting systems

Information technology (IT) is now essential to the development and delivery of health services. Healthcare professionals, including nurses, need appropriate educational training to enable them to use IT adequately because care is shared within multiprofessional teams in both hospitals and the community. In particular, primary care nurses have had less access than other health professionals to IT training and fewer opportunities to benefit from IT. Furthermore, there is little evidence in the literature on the current situation of IT training needs and requirements for primary care nurses. The PRACTIS (PRimary care nurses Access to Communications Technology and Informatics Skills) UK-based project has addressed these issues through an empirical investigation to establish a picture of the current primary care situation. This was done using a questionnaire, followed by practicing nurse focus groups. Directions for further work in the IT training of primary care nurses are discussed, together with recommendations to investigate the effect that the organization of the work within primary care groups may have on nurses' use and access to communications technology and informatics skills.

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Background: Wild-type transthyretin amyloidosis (wtATTR) is an important cause of heart failure (HF); however, the prevalence and clinical significance of neurologic complications remains uncertain. Methods: This analysis reports findings from a single-centre experience of routine neuropathy screening at the time of wtATTR diagnosis by nerve conduction studies and neurologist assessment, compared with age-matched controls. Results: Forty-one wtATTR patients were included, 39 (95%) males, mean age 78.4 ± 7.7 years, 22 (54%) New York Heart Association (NYHA) class III–IV HF, along with 15 age-matched controls (mean age 77.1 ± 4.2 years, 80% male). Twenty-one (51%) wtATTR patients were diagnosed with polyneuropathy, 15 (37%) with spinal stenosis, 36 (88%) with carpal tunnel syndrome (CTS) and 14 (34%) with ulnar neuropathy. Comparison diagnoses among controls were 1 (7%), 0, 1 (7%) and 3 (20%), respectively. Among patients with NYHA class III–IV HF, 16 (73%) had polyneuropathy compared with 5 (26%) with class I–II (p < 0.01), odds ratio of 7.5 (95% confidence interval 1.9–29.9). After neuropathy screening, 19 (46%) patients were offered neurologic therapy and/or additional diagnostic evaluation. This included CTS release surgery (16, 39%), neuropathic pain medication (3, 7%), nerve block (1, 2%), wrist splinting (2, 5%) and foot care (1, 2%). Spine imaging was performed for 3 (7%) patients, and deltoid muscle and sural nerve biopsy for 1 (2%) patient. Conclusions: Screening of wtATTR patients for neurologic complications resulted in a management change for nearly half. CTS, polyneuropathy and ulnar neuropathy were common. This approach warrants consideration as part of routine assessment for newly diagnosed wtATTR patients.