1,162 research outputs found

    Implications for telehealth for accessing education in rural areas: children with a severe chronic disease.

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    Children and their families who live in rural and remote areas are often disadvantaged by distance. In healthcare, this can be especially problematic. Children can suffer from a range of chronic conditions, e.g. diabetes, asthma, cardiac conditions, cystic fibrosis and others. In Australia, health services for children and families with such conditions are centred in specialist children’s hospitals in the capital cities in each state, but the burden of health care often falls to the parents and the children themselves. While rural health services do a wonderful job providing health care for these children, it is very rare to find specialist services in any rural situation. For example, children with cystic fibrosis who live in remote parts of Queensland attend specialist clinics in their local hospital twice or three times a year for routine check-ups, when the cystic fibrosis team of nurses, doctors and allied health staff from the children’s hospital in Brisbane travels to rural areas. If children become acutely ill, they might be able to be treated in the local hospital if they are not too sick, or they could be taken to the children’s hospital in Brisbane by their parents. If they are having a serious exacerbation of the illness, they will be transported there by aircraft and ambulance. Any child being sick is stressful for the family, regardless of where they live. However, if families live thousands of kilometres from the main treatment centres, scenarios described above can be common, with subsequent family disruption and emotional, social and economic costs. Telehealth is being installed in many rural and remote health services, thereby allowing country families the benefit of specialist consultation and care. However, governments and health departments are only slowly engaging with such technology. This paper presents findings of a study in Far North Queensland which examined how care was delivered to rural and remote families with children with cystic fibrosis, and how they cope. It will discuss how telehealth could improve care to such families and pose questions about why this is so slow in being implemented in Australia

    Inhibition of alpha7 nicotinic receptors in the ventral hippocampus selectively attenuates reinstatement of morphine‐conditioned place preference and associated changes in AMPA receptor binding

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    Recurrent relapse is a major problem in treating opiate addiction. Pavlovian conditioning plays a role in recurrent relapse whereby exposure to cues learned during drug intake can precipitate relapse to drug taking. α7 nicotinic acetylcholine receptors (nAChRs) have been implicated in attentional aspects of cognition and mechanisms of learning and memory. In this study we have investigated the role of α7 nAChRs in morphine‐conditioned place preference (morphine‐CPP). CPP provides a model of associative learning that is pertinent to associative aspects of drug dependence. The α7 nAChR antagonist methyllycaconitine (MLA; 4 mg/kg s.c.) had no effect on the acquisition, maintenance, reconsolidation or extinction of morphine‐CPP but selectively attenuated morphine‐primed reinstatement of CPP, in both mice and rats. Reinstatement of morphine‐CPP in mice was accompanied by a selective increase in [3H]‐AMPA binding (but not in [3H]‐MK801 binding) in the ventral hippocampus that was prevented by prior treatment with MLA. Administration of MLA (6.7 ÎŒg) directly into the ventral hippocampus of rats prior to a systemic priming dose of morphine abolished reinstatement of morphine‐CPP, whereas MLA delivered into the dorsal hippocampus or prefrontal cortex was without effect. These results suggest that α7 nAChRs in the ventral hippocampus play a specific role in the retrieval of associative drug memories following a period of extinction, making them potential targets for the prevention of relapse

    My Care, I Care: A study of what people with HIV value about NHS HIV services across London

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    Duration: January 2012 - March 2013 As part of a larger review of HIV services in London, the London Specialised Commissioning Group (SCG) commissioned Sigma Research to investigate the views of people with diagnosed HIV about the London NHS HIV services provided to them. The final report from the research, which included a large-scale self-completion survey and eight focus groups, is available to download here. It is also available in printed format, free to UK addresses here. Almost 1400 people with diagnosed HIV self-completion the survey which was available in HIV clinics and online from early February to the end of July 2012. The survey covered: demographics, current service use, motivations for service choice, aspirations for service development and broader social care needs. Sampling and recruitment were controlled in an attempt to ensure a sample broadly representative of the population of people using HIV clinical services in London and to ensure representation from all 28 London clinics. The survey was promoted online by HIV organisations and some HIV clinics. In addition paper copies of the survey were administered by dedicated fieldworkers in all the 28 specialist HIV out-patients clinics in Greater London. Eight focus groups with key groups of people with HIV were used to investigate in more detail motivations for service use, satisfaction with services and aspirations and suggestions for service development

    What do you need? 2007-08 findings from a national survey of people with diagnosed HIV

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    Over the past twenty-five years, both the needs of people with diagnosed HIV and our understanding of them have changed dramatically. During this time there have been many assessments of need, usually within specific geographic boundaries (such as Primary Care Trusts) but no consistent approach to describing needs has been adopted. Most needs assessments have been shaped by a variety of local factors, including the profile of existing services. This study provides an insight into the needs of people with diagnosed HIV living in the UK, based on a final sample of 1777 people. The approach taken to measuring and describing need is the same as our previous national survey (Weatherburn et al. 2002). This approach was shaped by our earlier qualitative studies exploring the experience of people with diagnosed HIV in the early days of anti-HIV treatments (Anderson et al. 2000, Anderson & Weatherburn 1999, Anderson & Weatherburn 1998). While this study uses the same methods as our 2001-2002 survey we do not draw direct comparisons with our previous data or discuss change over time. The limitations of self-completion surveys using convenience samples make change comparisons hazardous. However, it is worth noting that in any comparison with our prior data (Weatherburn et al. 2002) current levels of need very rarely seem lower than we have previously reported. The range and extent of medical and social care, support and information needs we present here reveal significant challenges for service commissioners and providers. The first challenge is to avoid drawing quick conclusions about what the patterns of need mean for service commissioning and delivery. Needs have deliberately been separated from service use because the question of what services are ‘needed’ cannot be answered simply by identifying the extent of personal needs. The overall pattern of need is a useful starting point, but this pattern is complex

    Plus One: HIV diagnosis and disclosure

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    Plus One: HIV sero-discordant relationships among black African people in England (NAHIP) Duration: September 2010 - November 2011 Plus One involved in-depth, face-to-face interviews with black African people living in England who were in relationships where one person had diagnosed HIV and the other did not (ie. HIV serodiscordant)

    Plus One: External Influences

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    Plus One: HIV sero-discordant relationships among black African people in England (NAHIP) Duration: September 2010 - November 2011 Plus One involved in-depth, face-to-face interviews with black African people living in England who were in relationships where one person had diagnosed HIV and the other did not (ie. HIV serodiscordant). Catherine Dodds, Peter , Annabel , Edith , John , Lawrence , Pamela , Kathie & Gary
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