Self-Management education for adults with poorly controlled epILEpsy [SMILE (UK)]: a randomised controlled trial

Epilepsy affects up to 1% of people in the UK and some would like to know more about living with epilepsy and managing their seizures. To help people who have epilepsy and a lot of seizures, we tested a group course called Self-Management education for adults with poorly controlled epILEpsy or SMILE (UK). The study had 404 people with epilepsy. People were asked questions about their general well-being (‘quality of life’), health, whether or not they felt worried or depressed, and how epilepsy had an impact on their lives. The study also aimed to find out what people thought about the course and whether or not it could lower the costs of epilepsy care. The results showed that people who were less happy with their general well-being may also feel depressed and worried, feel that others treat them differently and feel less able to control their epilepsy. They may not take their medicine as they should and they may have other health problems or a lot of seizures. At the end of the study, general well-being was the same between the people who took the course and those who did not. The course was not found to save costs for epilepsy treatment, but people said that learning in a group helped them feel less alone and let them open up to discuss feelings. They were also more confident, which improved their outlook and coping with epilepsy. However, some said that they had trouble recalling parts of the course because of memory problems. The study testing SMILE (UK) for people with epilepsy in groups did not find any difference in general well-being in people 1 year after attending the course. But the course gave people the chance to learn from experts and, by talking with others, they felt less alone and more confident

Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients

<p>Abstract</p> <p>Background</p> <p>The effects of tobacco, physical exercise, diet, and alcohol consumption on morbidity and mortality underline the importance of health promotion and prevention (HPP) at the primary health care (PHC) level. Likewise, the deficiencies when putting such policies into practice and assessing their effectiveness are also widely recognised. The objectives of this research were: a) to gain an in-depth understanding of general practitioners' (GPs) and patients' perceptions about HPP in PHC, and b) to define the areas that could be improved in future interventions.</p> <p>Methods</p> <p>Qualitative methodology focussed on the field of health services research. Information was generated on the basis of two GP-based and two patient-based discussion groups, all of which had previously participated in two interventions concerning healthy lifestyle promotion (tobacco and physical exercise). Transcripts and field notes were analysed on the basis of a sociological discourse-analysis model. The results were validated by triangulation between researchers.</p> <p>Results</p> <p>GPs and patients' discourses about HPP in PHC were different in priorities and contents. An overall explanatory framework was designed to gain a better understanding of the meaning of GP-patient interactions related to HPP, and to show the main trends that emerged from their discourses. GPs linked their perceptions of HPP to their working conditions and experience in health services. The dimensions in this case involved the orientation of interventions, the goal of actions, and the evaluation of results. For patients, habits were mainly related to ways of life particularly influenced by close contexts. Health conceptions, their role as individuals, and the orientation of their demands were the most important dimensions in patients' sphere.</p> <p>Conclusions</p> <p>HPP activities in PHC need to be understood and assessed in the context of their interaction with the conditioning trends in health services and patients' social micro-contexts. On the basis of the explanatory framework, three development lines are proposed: the incorporation of new methodological approaches according to the complexity of HPP in PHC; the openness of habit change policies beyond the medical services; and the effective commitments in the medium to long term by the health services themselves at the policy management level.</p

Simultaneous Gas Storage and Catalytic Gas Production Using Zeolites-A New Concept for Extending Lifetime Gas Delivery

Copper containing MCM-41 materials can be used to both store gaseous nitric oxide and to catalytically produce nitric oxide from nitrite. The active species for the reaction is copper (I). Addition of cysteine to the solution in contact with the material has different effects depending on how much Cu(I) is present. This is a new method of extending the lifetime of gas delivery from a gas storage material.</p