The Role Of Local Authorities In Health Issues: A Policy Document Analysis

Prior to the passing of the Health and Social Care Act 2012 the Communities and Local Government (CLG) Select Committee conducted an investigation into the proposed changes to the Public Health System in England. The Committee considered 40 written submissions and heard oral evidence from 26 expert witnesses. Their report, which included complete transcripts of both oral and written submissions, provided a rich and informed data on which to base an analysis of the proposed new public health system. This report analyses the main themes that emerged from the evidence submissions and forms part of our preliminary work for PRUComm’s PHOENIX project examining the development of the new public health system

Dual Mexican-American Nationality: A Vehicle to Investment

This article will attempt to answer some of the basic and common questions concerning Natural dual Mexican-American Citizenship

Dual Mexican-American Nationality: A Vehicle to Investment

This article will attempt to answer some of the basic and common questions concerning Natural dual Mexican-American Citizenship

Requirements and access needs of patients with chronic disease to their hospital electronic health record: results of a cross-sectional questionnaire survey

Objectives: To identify patient’s views on the functionality required for personalised access to the secondary care EHR and their priorities for development. Design: Quantitative analysis of a cross-sectional self-complete survey of patient views on required EHR functionality from a secondary care EHR, including a patient ranking of functionality. Setting: Secondary care patients attending a regional cystic fibrosis unit in the north of England Participants: 201 adults [106 (52.7%) male], median age 29 years (range 17-58 years) entered and completed the study. Inclusion criteria; a confirmed diagnosis of CF, aged 16 years and over, at a time of clinical stability Outcome measures: Quantitative responses within 4 themes; 1) value placed on aspects of the EHR; 2) access requirements to functions of the EHR; 3) views on information sent to the EHR 4) patient feedback entered into the EHR. A ranked score for 15 functions of the EHR was obtained Results: Highest ratings (% reporting item as very important/important) were reported for access to clinical measures [lung function (94%), CRP (84%), sputum microbiology (81%) and blood results (80%)], medication changes (82%) and lists (83%) and sending repeat prescription (83%) and treatment requests (80%), whilst sending symptom diaries was less so (62%). Email contact with clinicians was the most valuable communication element of the EHR (84% very important/important). Of 15 features of the EHR [1=most desirable to 15=least desirable) patients identified ‘clinical measures’ [2.62 (CI 2.07-3.06)], and ‘access to medication lists’ [4.91 (CI 4.47-5.44)], as highest priority for development and the ability to comment on errors/ommissions [11.0 (CI 10.6-11.5)] or experience of care [11.8 (CI 11.4-12.2)] as lowest. Conclusions: Patients want extensive personal access to their hospital EHR, placing high importance on the viewing of practical clinical measures and medication management. These influence routine day to day care and are priorities for developmen

A pilot study of zafirlukast as an anti-inflammatory agent in the treatment of adults with cystic fibrosis

AbstractBackground: Persistent endobronchial inflammation is in part responsible for the attrition of lung function seen in cystic fibrosis. Leukotrienes act as pro-inflammatory mediators. The aim of this study was to assess the efficacy of the leukotriene receptor antagonist zafirlukast as a potential anti-inflammatory agent in the treatment of adult patients with cystic fibrosis. Methods: Clinically stable patients were enrolled in the study if they had no history or clinical evidence of asthma, bronchial hyper-reactivity, or aspergillosis. They were randomised to receive zafirlukast 20 mg twice daily with all routine treatment for four months or routine treatment alone in an open cross-over design. Primary endpoints were changes in respiratory function tests and a modified NIH clinical score. Results: Thirty patients were enrolled and 25 completed. There was a significant improvement in the modified NIH clinical score but no significant increase in respiratory function with zafirlukast. Conclusions: Patients receiving a leukotriene receptor antagonist in addition to routine treatments showed significant improvement in a clinical score which is a composite of clinical wellbeing, chest radiograph appearance, and physical examination. Respiratory function showed a non-significant trend towards improvement with treatment. Zafirlukast may benefit patients with CF. An adequately powered study is justified on the basis of these results

Construction of an instant structured illumination microscope

A challenge in biological imaging is to capture high-resolution images at fast frame rates in live cells. The “instant structured illumination microscope” (iSIM) is a system designed for this purpose. Similarly to standard structured illumination microscopy (SIM), an iSIM provides a twofold improvement over widefield microscopy, in x, y and z, but also allows much faster image acquisition, with real-time display of super-resolution images. The assembly of an iSIM is reasonably complex, involving the combination and alignment of many optical components, including three micro-optics arrays (two lenslet arrays and an array of pinholes, all with a pitch of 222 μm) and a double-sided scanning mirror. In addition, a number of electronic components must be correctly controlled. Construction of the system is therefore not trivial, but is highly desirable, particularly for live-cell imaging. We report, and provide instructions for, the construction of an iSIM, including minor modifications to a previous design in both hardware and software. The final instrument allows us to rapidly acquire fluorescence images at rates faster than 100 fps, with approximately twofold improvement in resolution in both x-y and z; sub-diffractive biological features have an apparent size (full width at half maximum) of 145 nm (lateral) and 320 nm (axial), using a 1.49 NA objective and 488 nm excitation