International guidelines for asthma management state that inhalation is the preferred route of drug delivery. Consequently, it is important to select an appropriate delivery device and to take account of a patient's preference and lifestyle, as incorrect inhaler use may lead to treatment failure. A large number of devices are available from which to select, but it may be difficult for healthcare professionals to provide guidance to the patient unless they are familiar with the characteristics and correct use of each device. Many factors affect the success of a device in a patient's hands: the device's features; the patient's psychosocial status, cultural beliefs, and language skills; and consistent instruction on inhalation technique. Constant education is essential to establish and maintain the patient's confidence in the treatment regimen. It is important that at least one member of the respiratory healthcare team should remain abreast of medical and pharmaceutical developments in the respiratory field. In this way, the choice of delivery device can be reviewed and changed to suit the changing needs of the patient.

Novel approaches including nonpharmacological methodologies for prevention and control of microbial pathogens and emerging antibiotic resistance are urgently needed. Procellera is a wound care device consisting of a matrix of alternating silver (Ag) and zinc (Zn) dots held in position on a polyester substrate with a biocompatible binder. This electroceutical medical device is capable of generating a direct current voltage (0.5-0.9 Volts). Wound dressings containing metals such as Ag and/or Zn as active ingredients are being used for control of colonized and infected wounds. Reports on the presence of electric potential field across epithelium and wound current on wounding have shown that wound healing is enhanced in the presence of an external electrical field. However, majority of the electrical devices require an external power source for delivering pulsed or continuous electric power at the wound site. A microelectric potential-generating system without an external power source is an ideal treatment modality for application in both clinical and field settings. The research presented herein describes efficacy evaluation of a wireless bioelectric dressing against both planktonic and biofilm forms of wound pathogens including multidrug resistant organisms.

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The NHS is becoming increasingly primary care and community focused and the role of the community nurse is becoming more significant, not just in managing long-term conditions and end of life but in providing vital help and education. Helping people become more knowledgeable about maintaining both their own health and that of their families at home or within the community is vital - the desired end being less need for expensive hospital care. As the demand to implement more complex services grows, so the need for nurses to contribute to the planning and delivery of services becomes more important. Nurses in the community have the experience and practical knowledge and must use it to influence commissioning and engage proactively, and positively, with current policy agendas and with the people whose responsibility it is to implement them. Change in primary care is constant and increasingly it is the frontline deliverers of services that drive that change and help set the agenda. As more care and treatment is devolved from the secondary to primary care setting, there must be greater integration between general practice and the community nursing team, with each helping and informing the other to deliver a world class primary care service.

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Purpose To describe the key objectives, aims, activities and vision for the International Nurse Practitioner/Advanced Practice Nursing Network (INP/PNN). Data Sources Selected publications and documents, personal experience, and commentary. Conclusions Advanced practice nursing and NP roles are prevalent in the United States and are now emerging in numerous countries throughout the world. There is a heightened interest among APNs and NPs internationally to share knowledge, expertise, and resources to enhance the presence of nursing in primary healthcare worldwide. The INP/APNN proposes to be an option for supporting the diversity of interna‐tional networking in this field. Implications for Practice Nurse practitioner and APN roles are emerging globally. Globalization and global health issues impact all health care practitioners. Collaboration, partnering, and networking have the potential of enhancing and advancing practice for both experienced practitioners and countries that are initiating APN roles.

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