Children with complex support needs in healthcare settings for prolonged periods: their numbers, characteristics and experiences

This report details the findings of research conducted in England and Scotland to identify how many children with complex support needs are spending longer than one month in healthcare settings in Scotland and England, how and why they are in hospital, why they have not been discharged home or to appropriate alternative community-based facilities, and how well the hospital or healthcare setting is meeting their emotional, social and educational needs. It finds that many of these children could and should be discharged but are not, for a variety of reasons: primarily the lack of appropriate resources in the community and poor discharge planning processes, coupled with the inability of their families to manage their care and supervision without intensive support. Hospitals and healthcare settings in many cases are not meeting their needs and these children are being denied the protection offered by UK legislation governing children's rights and welfare

Combined ultraviolet studies of astronomical sources

Ultraviolet studies of astronomical sources are discussed. Some studies utilized IVE data. Non-radiative shock at the edge of the Cygnses Loop, stellar flares, local interestellar medium, hot galaxies, stellar mass ejection, contact binaries, double quasars, and stellar chromosphere and coronae are discussed

Precision medicine and adverse drug reactions related to cardiovascular drugs

Cardiovascular disease remains the leading global cause of death. Early intervention, with lifestyle advice alongside appropriate medical therapies, is fundamental to reduce patient mortality among high-risk individuals. For those who live with the daily challenges of cardiovascular disease, pharmacological management aims to relieve symptoms and prevent disease progression. Despite best efforts, prescription drugs are not without their adverse effects, which can cause significant patient morbidity and consequential economic burden for healthcare systems. Patients with cardiovascular diseases are often among the most vulnerable to adverse drug reactions due to multiple co-morbidities and advanced age. Examining a patient’s genome to assess for variants that may alter drug efficacy and susceptibility to adverse reactions underpins pharmacogenomics. This strategy is increasingly being implemented in clinical cardiology to tailor patient therapies. The identification of specific variants associated with adverse drug effects aims to predict those at greatest risk of harm, allowing alternative therapies to be given. This review will explore current guidance available for pharmacogenomic-based prescribing as well as exploring the potential implementation of genetic risk scores to tailor treatment. The benefits of large databases and electronic health records will be discussed to help facilitate the integration of pharmacogenomics into primary care, the heartland of prescribing

Human skeletal muscle feed arteries: evidence of regulatory potential

Aim Recently, it has been recognized that human skeletal muscle feed arteries can be harvested during exploratory surgery for melanoma. This approach provides vessels for in vitro study from a wide spectrum of relatively healthy humans. Although, the regulatory role of skeletal muscle feed arteries in rodent models has been documented, whether such vessels in humans possess this functionality is unknown. Methods Therefore, skeletal muscle feed arteries (~950 μm OD) from 10 humans (48 ± 4, 27–64 years) were studied using pressure myography. Vessel function was assessed using potassium chloride (KCl), phenylephrine (PE), acetylcholine (ACh) and sodium nitroprusside (SNP) concentration–response curves (CRCs) to characterize non-receptor and receptor-mediated vasoconstriction as well as endothelium-dependent and independent vasodilation respectively. To understand the physiological relevance of the diameter changes as a result of pharmacological stimulation, the estimated conductance ratio (CR) was calculated. Results Vessel function protocols revealed significant vasoconstriction in response to PE and KCl (35 ± 6; 43 ± 9%vasoconstriction, respectively) and significant vasodilation with ACh and SNP (85 ± 7; 121 ± 17% vasodilation, respectively). Both PE and KCl significantly reduced the CR (0.26 ± 0.05 and 0.23 ± 0.07, respectively), whereas ACh and SNP increased the CR (2.56 ± 0.10 and 5.32 ± 1.3, respectively). Conclusion These novel findings provide evidence that human skeletal muscle feed arteries are capable of generating significant diameter changes that would translate into significant changes in vascular conductance. Thus, human skeletal muscle feed arteries likely play a significant role in regulating vascular conductance and subsequently blood flow in vivo