‘I haven’t said goodbye to my kids’

People diagnosed with anaphylaxis in adulthood face unique, but largely ignored, psychological challenges. Psychology offers insights for understanding their needs, and the development of interventions to help this growing group live with severe allergies

Accelerated discharge of patients in the event of a major incident: observational study of a teaching hospital

BACKGROUND: Since October 2002 in the UK Primary Care Trusts (PCTs) have had statutory responsibility for having and maintaining a Major Incident plan and since 2005 they have been obliged to co-operate with other responders to an incident. We aimed to establish the number of beds in our Trust which could be freed up over set periods of time in the event of a major incident and the nature and quantity of support which might be required from PCTs in order to achieve this. METHODS: Repeated survey over 12 days in 3 months of hospital bed occupancy by type of condition and discharge capacity in an 855-bed UK tertiary teaching hospital also providing secondary care services. Outcome measures were bed spaces which could be generated, timescale over which this could happen and level and type of PCT support which would be required to achieve this. RESULTS: Mean beds available were 78 immediately, a further 69 in 1–4 hours and a further 155 in 4–12 hours, generating a total of 302 beds (36% of hospital capacity) within 12 hours of an incident. This would require support from a PCT of 150,000 population of 10 nursing care beds, 20 therapy-supported intermediate care beds, and 25 care packages in patients' own homes. CONCLUSION: In order to fulfill the requirements of the Civil Contingencies Act 2004, PCTs should plan to have surge capacity in the order of 30 residential placements and 25 community support packages per 150,000 population to support Acute Trusts in the event of a major incident

Sensitization of the histamine H1 receptor by increased ligand affinity.

Histamine regulates a variety of physiological processes including inflammation, gastric acid secretion, and neurotransmission. The cellular response to histamine is subject to dynamic control, and exaggerated histamine reactivity in response to cysteinyl leukotrienes and other stimuli is important in a variety of different pathological conditions. The molecular mechanisms controlling histamine responsiveness are still unresolved. In investigating histamine responses in embryonic stem (ES5) and F9 embryonic carcinoma cells, we encountered a novel mechanism controlling the cellular reaction to histamine. Unstimulated cells displayed neither

A Qualitative Study of Factors Relating to Motivation in Pulmonary Rehabilitation

1. Background Motivation is acknowledged as being important within pulmonary rehabilitation, yet there is very little research within this topic. Additionally there is no universal definition of motivation. 2. Aims The purpose of the study was to gain insight into patient perceptions of the meaning of motivation and factors influencing it within the specific context of a pulmonary rehabilitation programme. 3. Methods A qualitative, phenomenological approach was used. Patient focus groups and interviews were undertaken to generate data about their beliefs, attitudes and experiences related to motivation within the context of pulmonary rehabilitation. Content analysis was performed, and data was coded and categorised. 4.Results Patients perceived motivation as consisting of essential elements, external influences and a behaviour element. Patients perceived an essentially motivated person as having a positive attitude, high self-esteem and self efficacy and as an independent person with a happy disposition. External influences included supportive healthcare professionals, the weather, and belief in effectiveness of rehabilitation. The data also showed that during pulmonary rehabilitation patients appear to experience a cycle of increasing motivation influenced by different elements at each stage. Patients perceived behaviour to be the manifestation of their motivational status. 5. Conclusions The study has provided evidence that there is potential to manipulate motivation within pulmonary rehabilitation. The data will be valuable in future exploration of the use of cognitive behavioural interventions within programmes