Older people's experiences of changed medication appearance : a survey

This report details a survey of older people's experiences of changed medication appearance. The aims of the study were: • To develop a questionnaire in partnership with older people to survey older people’s views on fluctuating medication appearance • To elicit older people’s experiences of medication that changed appearance due to ‘generic prescribing’ and ‘parallel import’ practices and its impact on their medication taking practices. These common pharmacy practices mean that the same tablet medication can be issued to older people in different colours, sizes and shapes to their previous prescriptions. Older people from a local User/Carer Forum highlighted these problems to the research team and asked that we investigate to explore the extent of the problem. An eight-item questionnaire was developed and distributed to 2000 older people (50 years+) across participating PCTs in Greater Manchester in 2008. A 29% response rate was achieved. The data was analysed using the SPSS statistical package. Findings include: •63.3% experienced a change in the appearance of their tablet medications. •74.1% did not seek advice regarding the change in the appearance of their tablet medications. •Older people noted changes to the actual tablets, tablet packaging and written information that accompanies tablets. Changes are occurring to the colour, size and shape of tablets more than changes to packaging and written information. The majority of respondents had experienced changes in the appearance of their prescribed tablet medication in the previous two years which were not due to change in medication or dose etc. Worryingly, for some respondents, these changes prompted negative experiences such as anxiety, confusion and upset. Of particular concern was that a small number omitted the affected tablet medications and did not seek help or advice from GPs, pharmacists or relatives. Six older people have been study advisors from inception to dissemination of this study and significantly added to its quality. The study demonstrates substantive public engagement / user involvement in research. The findings suggest nurses and others have a role to play in promoting better medicines management and identifying those most at risk from changed appearance of medications

Intermediate-mass Black Holes in Galactic Nuclei

We present the first homogeneous sample of intermediate-mass black hole candidates in active galactic nuclei. Starting with broad-line active nuclei from the Sloan Digital Sky Survey, we use the linewidth-luminosity-mass scaling relation to select a sample of 19 galaxies in the mass range M_BH ~ 8 x 10^4 - 10^6 solar masses. In contrast to the local active galaxy population, the host galaxies are ~1 mag fainter than M* and thus are probably late-type systems. The active nuclei are also faint, with M_g ~ -15 to -18 mag, while the bolometric luminosities are close to the Eddington limit. The spectral properties of the sample are compared to the related class of objects known as narrow-line Seyfert 1 galaxies. We discuss the importance of our sample as observational analogues of primordial black holes, contributors to the integrated signal for future gravitational wave experiments, and as a valuable tool in the calibration of the M-sigma relation.Comment: 4 pages, 4 figures. To appear in "The Interplay among Black Holes, Stars and ISM in Galactic Nuclei," Proc. IAU 222 (Gramado, Brazil), eds Th. Storchi Bergmann, L.C. Ho, H.R. Schmit