Potentially, after further testing, this instrument could be used by nursing management and educators to measure clinical leadership needs, inform the design of clinical leadership training programmes and provide valuable information about health care leadership development.

Aim To explore the differences in perceived importance and actual performance of clinical leadership for all grades of nurses and midwives engaged in clinical practice. Background Clinical leadership is central to the provision of person‐centred care. However, little is known about how nurses and midwives perceive this in practice. Methods Data were collected on a sample of nurses and midwives in the Republic of Ireland, using a cross‐sectional study design (n = 324). The clinical leadership needs analysis instrument was used to measure perceived importance and performance of clinical leadership in practice. Grades of nurses/midwives included; staff, manager, advanced practitioner and senior manager. Results Senior managers were more likely to report significantly higher scores than staff grades for perceived importance of Technology & Care Initiatives (p < .01) and Financial & Service Management (p = .02). Performance of Staff & Care Delivery was significantly higher for senior managers than staff grades [F(5,309) = 6.06 p < .01]. Conclusion There was a mismatch between the perceived importance and actual performance of clinical leadership in practice between different grades of staff. Implications for Nursing Management Leadership training for all grades and mentoring of staff grades can promote the building of confidence and empower staff in leading clinical practice.

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The news comes. What was feared is now a reality. Devastation. The words “you”, “breast” and “cancer” echo throughout the room. What happens now? Who do you turn to? Nearly 3,000 women are diagnosed with breast cancer in Ireland on an annual basis. The above scenario for them is very much a reality. A diagnosis of cancer is devastating. It is not only the disease itself but the treatments, life alteration and in some cases acceptance of defeat that the person endures. With cancer it is rarely one individual who suffers. With breast cancer (one of the most commonly diagnosed cancers in Ireland) an invasion on the woman’s identity can occur, bringing great distress. The people who support women with breast cancer throughout the diagnosis and disease play a vital part in the maintenance of the woman’s wellbeing. It is human nature to seek out comfort from other people. The ...

Background There is a need to develop novel drugs that will improve survival in breast cancer patients. Angiogenesis is essential for breast tumour progression. To date, the most promising approach to inhibit angiogenesis in breast cancer patients has been the drug bevacizumab which targets the pro-angiogenic factor Vascular Endothelial Growth Factor (VEGF). Recently, there has been controversy regarding the efficacy of bevacizumab for breast cancer treatment. In clinical trials, bevacizumab failed to establish an overall-survival benefit and was associated with serious toxicities. This resulted in the FDA revoking approval for the drug for the first line treatment of advanced breast cancer. Due to this uncertainty surrounding the efficacy of bevacizumab for the treatment of breast cancer it is clear that there is a clinical need for more effective novel anti-angiogenic drugs with better toxicity profiles for the treatment of breast cancer. Aim This study aimed to identify novel small-molecule anti-angiogenic agents with therapeutic potential in human breast cancer. Methods Compounds with physiochemical properties consistent with drug-like compounds were screened for anti-angiogenic activity by high-throughput screening involving zebrafish larvae. Human breast tumour explants were treated with the lead compound and secretion of angiogenic factors was assessed by ELISA. Results We have identified a novel small-molecule agent ‘SMG1’ that significantly inhibited inter-segmental blood-vessel development in zebrafish and showed no toxicity. Treatment of breast tumour explants with SMG1 significantly inhibited secretion of the potent pro-angiogenic cytokine VEGF (p = 0.01). Furthermore, SMG1 inhibited VEGF secretion more than the standard targeted breast cancer therapies tamoxifen and Herceptin® which have been reported to inhibit angiogenesis. Conclusion Continuing pre-clinical work will determine if SMG1 has potential as a therapeutic agent for human breast cancer. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-09-16.

Substantial evidence describing cancer survivors' unmet physical, psychological and social needs have prompted growing attention to the delivery of supportive care in survivorship. Surveillance, follow-up, symptom management, and self-management support are significant components of survivorship care that may overcome unmet needs and promote survivors' well-being. However, a variety of factors including access, navigation, continuity of information, and the structure of interventions, may influence the uptake of care by cancer survivors, thereby limiting the potential positive impact of these services.

Background Antipsychotic medications are commonly used in the management of non-cognitive symptoms of dementia (also termed behavioural and psychological symptoms of dementia), such as agitation, calling out, hoarding, or aggression. This is despite increased recognition of adverse effects, including mortality, from these medications for people with dementia. The current aim was to review the most recent evidence for the efficacy and safety of antipsychotic medications in the management of non-cognitive symptoms in dementia. Methods Relevant studies published in English from March 2015 through to March 2018 were identified by searches of 5 databases: Medline, EBSCO, PsycINFO, Cochrane DARE, and Cochrane CENTRAL. Systematic reviews, meta-analyses, and controlled trials evaluating the safety of antipsychotic medication, or comparing the effectiveness of antipsychotic medication with placebo, another antipsychotic medication, or non-pharmacological intervention, were included. Independent article review and data extraction was performed by two reviewers. Study quality was appraised using the Joanna Briggs Institute critical appraisal tools. Results Thirteen studies were included. Benefits and harms vary among antipsychotic medications for people with dementia, however overall efficacy of antipsychotics remains modest at best. A significant number of side effects are associated with antipsychotics, not least cerebrovascular events, sedation, gait disturbances, falls, fractures, urinary tract infections, cognitive worsening, and mortality. Atypical antipsychotics have a more favourable safety profile in some respects. People with certain dementias, notably Lewy Body Dementia, may experience more severe side-effects. Conclusion The evidence reinforces caution when prescribing antipsychotic medications for people with dementia; these medications should only be considered when symptoms are severe or non-pharmacological interventions have failed. Clinicians should closely monitor people with dementia who are prescribed an antipsychotic for side effects, limiting use of these medications to short-term treatment if possible. The forthcoming national clinical guideline for appropriate prescribing of psychotropic medications for non-cognitive symptoms will support clinical decision-making in this regard.