Overcoming the fear: an autoethnographic narrative of running with epilepsy

Through a phenomenological approach, this article explores the identity conflict that arose within a female runner after diagnosis with epilepsy. Utilising a three month autoethnography to track her experiences of returning to running, the first author narrates the effect of epilepsy on her identity formation. Providing a voice that is absent from a research area dominated by statistics, the reader is asked to involve him/herself in the world of this athlete and in turn embrace the use of narratives as a valuable coping mechanism for those with chronic disorders

Decorin transfection induces proteomic and phenotypic modulation in breast cancer cells 8701-BC

Decorin is a prototype member of the small leucine-rich proteoglycan family widely distributed in the extracellular matrices of many connective tissues, where it has been shown to play multiple important roles in the matrix assembly process, as well as in some cellular activities. A major interest for decorin function concerns its role in tumorigenesis, as growth-inhibitor of different neoplastic cells, and potential antimetastatic agent. The aim of our research was to investigate wide-ranged effects of transgenic decorin on breast cancer cells. To this purpose we utilized the well-characterized 8701-BC cell line, isolated from a ductal infiltrating carcinoma of the breast, and two derived decorin-transfected clones, respectively, synthesizing full decorin proteoglycan or its protein core. The responses to the ectopic decorin production were examined by studying morphological changes, cell proliferation rates, and proteome modulation. The results revealed new important antioncogenic potentialities, likely exerted by decorin through a variety of distinct biochemical pathways. Major effects included the downregulation of several potential breast cancer biomarkers, the reduction of membrane ruffling, and the increase of cell-cell adhesiveness. These results disclose original aspects related to the reversion of malignant traits of a prototype of breast cancer cells induced by decorin. They also raise additional interest for the postulated clinical application of decori

National survey of clinical pharmacy services

Objective: To determine the extent of provision of clinical pharmacy services in Australian hospitals and documentation relating to these. Further to evaluate the suitability of the information collected to demonstrate the benefits of these services. Method: The National Survey of Clinical Pharmacy Services (NSCPS) was undertaken during October 1995. A questionnaire was sent to 309 public and private hospitals which sought information on a range of clinical pharmacy services in major areas of clinical pharmacy practice. The information requested concerned the frequency of provision of the service and any specific information thought to demonstrate the benefit(s) of the service. Following review of responses to the questionnaire pharmacy departments were identified for follow-up to obtain more detailed information on the type and extent of documentation available. This information was then used to make recommendations concerning the applicability of the available information within each clinical service for collation and further study. Results: The prevalence of clinical pharmacy services within four broad areas of clinical pharmacy practice based on data from 111 respondents was: drug therapy monitoring, 96%; provision of drug information and education, 98%; drug utilisation reviews and evaluations and the promulgation of therapeutic guidelines and protocols, 96%; and community liaison services, 78%. The type and extent of documentation relating to each clinical pharmacy service varied amongst hospitals. Conclusion: The survey demonstrated that clinical pharmacy services arc common within Australian hospitals. Furthermore, documentation relating to these services was widespread. The nature of the documentation, however varied amongst institutions. This variation limits the usefulness of the information for nation-wide collation and further study. There is a need to standardise the type of information collected for each clinical pharmacy service in order to allow collation of information from multiple centres

A comparative study on biochemical markers of bone collagen breakdown in post-menopausal women.

The aim of this study was to compare urinary galactosylhydroxylysine (GHyl) and deoxypyridinoline (d-Pyr) as biochemical markers of bone resorption in post-menopausal women treated and untreated with estrogen and cyclic etidronate. Fasting urinary GHyl, D-Pyr, pyridinoline, serum osteocalcin and total alkaline phosphatase were measured in three subgroups, i.e. post-menopausal women undergoing hormone replacement therapy, untreated post-menopausal women and post-menopausal women with low BMD treated with disodium etidronate. The results indicated that GHyl did not significantly discriminate between untreated post-menopausal women and estrogen replated ones unless an osteoporotic untreated group was selected. d-Pyr and GHyl showed similar performances when their values after bisphosphonate treatment were compared to those found in untreated post-menopausal women, thus suggesting that both markers were equal in their ability to detect the bone response to cyclic etidronate administration. This observation further proves the statement that GHyl is prone to confounding factors under estrogen therapy but it is adequate as is d-Pyr in monitoring the bone response to bisphosphonate treatment

A methodological framework for estimating the clinical and economic value of community pharmacists’ clinical interventions using expert opinion

What is known and Objective: Studies of the outcomes of clinical interventions (CIs) performed by community pharmacists are limited. The economic models used in most studies of CIs have been simplistic, often failing to fully capture the counterfactual when estimating savings in health resources resulting from CIs. This paper aimed to describe the complexities involved in estimating the clinical and economic outcomes of CIs performed by community pharmacists when using expert opinion and suggest avenues for improvement. Methods: Existing models were reviewed, from which a range of key parameters required to evaluate the outcomes of CIs were identified. The considerations necessary to generate potentially more robust estimates of these parameters were discussed. Results and Discussion: CIs performed by community pharmacists may result in a multitude of effects on numerous health services. By utilizing the approaches described in this paper, researchers working in this field should be able to generate improved estimates of health resource savings and quality of life effects resulting from CIs performed by community pharmacists, when compared to previous efforts. What is new and Conclusion: This article offers recommendations designed to improve the robustness of evaluation when using expert opinion to evaluate CIs performed by community pharmacists

The potential for intelligent decision support systems to improve the quality and consistency of medication reviews

What is known and Objective: Drug-related problems (DRPs) are of serious concern worldwide, particularly for the elderly who often take many medications simultaneously. Medication reviews have been demonstrated to improve medication usage, leading to reductions in DRPs and potential savings in healthcare costs. However, medication reviews are not always of a consistently high standard, and there is often room for improvement in the quality of their findings. Our aim was to produce computerized intelligent decision support software that can improve the consistency and quality of medication review reports, by helping to ensure that DRPs relevant to a patient are overlooked less frequently. A system that largely achieved this goal was previously published, but refinements have been made. This paper examines the results of both the earlier and newer systems. Methods: Two prototype multiple-classification ripple-down rules medication review systems were built, the second being a refinement of the first. Each of the systems was trained incrementally using a human medication review expert. The resultant knowledge bases were analysed and compared, showing factors such as accuracy, time taken to train, and potential errors avoided.Results and Discussion: The two systems performed well, achieving accuracies of approximately 80% and 90%, after being trained on only a small number of cases (126 and 244 cases, respectively). Through analysis of the available data, it was estimated that without the system intervening, the expert training the first prototype would have missed approximately 36% of potentially relevant DRPs, and the second 43%. However, the system appeared to prevent the majority of these potential expert errors by correctly identifying the DRPs for them, leaving only an estimated 8% error rate for the first expert and 4% for the second. What is new and conclusion: These intelligent decision support systems have shown a clear potential to substantially improve the quality and consistency of medication reviews, which should in turn translate into improved medication usage if they were implemented into routine use

Cyclist Aerodynamics: A Comparison Between Wind Tunnel Tests and CFD Simulations for Helmet Design

During the last decades, a particular attention has been paid to the aerodynamic optimization of professional bike riders and their equipment, with a large use of experimental investigation as well as numerical simulations. Extensive studies have been carried out in wind tunnels all over the world by professional cycling teams to study the best set-up for time trial competitions. The standard approach is to compare different parts of the equipment or different positions and find out the optimized configuration by a trial and error procedure. This paper presents an attempt of helmet design based on CFD calculations and experimental validation of numerical results with a new experimental set-up able to measure the surface pressure on a real helmet

Cyclist Aerodynamics: A Comparison Between Wind Tunnel Tests and CFD Simulations for Helmet Design

During the last decades, a particular attention has been paid to the aerodynamic optimization of professional bike riders and their equipment, with a large use of experimental investigation as well as numerical simulations. Extensive studies have been carried out in wind tunnels all over the world by professional cycling teams to study the best set-up for time trial competitions. The standard approach is to compare different parts of the equipment or different positions and find out the optimized configuration by a trial and error procedure. This paper presents an attempt of helmet design based on CFD calculations and experimental validation of numerical results with a new experimental set-up able to measure the surface pressure on a real helmet