Mycotoxins revisited: Part II

Mushrooms are ubiquitous in nature. They are an important source of nutrition, however, certain varieties contain chemicals that can be highly toxic to humans. Industrially cultivated mushrooms are historically very safe, whereas foraging for mushrooms or accidental ingestion of mushrooms in the environment can result in serious illness and death. The emergency department is the most common site of presentation for patients suffering from acute mushroom poisoning. Although recognition can be facilitated by identification of a characteristic toxidrome, the presenting manifestations can be variable and have considerable overlap with more common and generally benign clinical syndromes. The goal of this two-part article is to review the knowledge base on this subject and provide information that will assist the clinician in the early consideration, diagnosis and treatment of mushroom poisoning. Part I reviewed the epidemiology and demographics of mushroom poisoning, the physical characteristics of the most toxic varieties, the classification of the toxic species, and presented an overview of the cyclopeptide-containing mushroom class. Part II is focused on the presentation of the other classes of toxic mushrooms along with an up-to-date review of the most recently identified poisonous varieties.     

Phenomenon of sudden death: Part I

This study investigates qualified nurses' experiences of the phenomenon of sudden death within the Accident and Emergency speciality. The author's objective was to deepen knowledge and understand the phenomenon from the perspective of nursing colleagues. The sample size was six participants drawn from the Accident and Emergency department of a large hospital in the South East of England, UK. A phenomenological approach was used: data collection being by unstructured interviews and analysis by using Hycner's (1985) approach. Four chronological themes were identified which form a structure to the nurses' experiences: encountering, facing, dealing with, and reflecting upon the phenomenon of sudden death. The results emphasize the value of reflective practice linked to effective and relevant training within a safe and supportive work environment. The research findings fully acknowledge the difficulty of coping with what can be one of the most stressful aspects of an Accident and Emergency nurse's role. Using phenomenology to understand the lived experience enhances the knowledge needed to minimize nurses' stress and increase their job satisfaction. The insights gained can significantly contribute to the provision of high quality holistic care for the suddenly bereaved.Part 1 of this paper covers sudden bereavement from the A & E nurse's point of view, the research design and methodology and the research findings.Part 2, which will be published in issue 5:4 of this journal, will present the discussion of the findings.