Blogging as a viable research methodology for young people with arthritis: a qualitative study.

The development of services that are responsive to the needs of users is a health policy priority. Finding ways of engaging young people in research to gain insights into their particular experiences, perspectives, and needs is vital but challenging. These data are critical to improving services in ways that meet the needs of young people

Patients' practices and experiences of using nebuliser therapy in the management of COPD at home.

How patients use their nebulisers at home is vital to ensure effective treatment and optimal health outcomes for patients with chronic obstructive pulmonary disease (COPD). The aim of the study was to identify the practicalities and problems associated with nebuliser use by patients with COPD at home, which may impact on the safety and effectiveness of therapy

Spectral entropy and haemodynamic response to surgery during sevoflurane anaesthesia

No Abstract. Southern African Journal of Anaesthesia and Analgesia Vol. 12(1) 2006: 21-2

A comparison of EEG spectral entropy with conventional quantitative EEG at varying depths of sevoflurane anaesthesia

Background and Aim: Recently an electroencephalographic (EEG) spectral entropy module (M-ENTROPY) for an anaesthetic monitor has become commercially available. We compared its performance as an indicator of the state of anaesthesia with that of an older conventional quantitative EEG (QEEG) module (M-EEG) by the same manufacturer (Datex-Ohmeda Division, Instrumentarium Corp., Helsinki, Finland). Methods: There were 40 ASA class I or II subjects, aged between 16-60 years, who underwent elective abdominal surgery. EEG data were collected from the printouts of the respective modules. The data presented here were related to four levels of anaesthesia: Pre-anaesthetic wakefulness (state A), 2% sevoflurane endtidal (ET) concentration after completion of surgery (state B), low ET sevoflurane concentrations (~ 0.5%) just prior to regaining responsiveness (state C), and post-anaesthetic responsiveness (state D). Results: In terms of the prediction probability (Pk statistic), response entropy (RE) and state entropy (SE) produced higher values (0.95-1.0) than the best performing QEEG variable, frontal amplitude (0.86-0.95). Only RE scores did not overlap between states A and B or between B and D. The misclassification of subjects between states C and D was far lower for RE (28%) than for any of the conventional QEEG measures (>90%). Conclusion: In on-line monitoring spectral entropy is superior in distinguishing states of anaesthesia and is also easier to use than conventional QEEG. It is speculated that the artefact rejection strategies accorded spectral entropy might significantly benefit conventional QEEG analysis.Key words: EEG spectral entropy, conventional QEEG, sevoflurane anaesthesiaSouthern African Journal of Anaesthesia & Analgesia Vol. 11 (3) 2005: 89-9

The in vitro identification and quantification of volatile biomarkers released by cystic fibrosis pathogens

There is interest in the development of exhaled breath tests for the detection of lower airway infection in children with cystic fibrosis. The first stage of this process is the identification of volatile organic compounds (VOCs) released into the gas phase by CF pathogens that can be used as breath test biomarkers. Selected ion flow tube mass spectrometry (SIFT-MS) is ideally suited to these in vitro studies as it allows simultaneous quantification of multiple VOCs in real time. We review a decade of in vitro experiments using SIFT-MS to analyse the VOCs released by respiratory pathogens. This includes identification and quantification of VOCs and the investigation of the in vitro factors that affect their production. We also report on how our culture methodology has been refined over the years to better account for variations in bacterial mass. Finally, we discuss how these in vitro findings have been translated into clinical trials and assess possible future applications

Applying the 'You're Welcome' youth-friendly service criteria to community pharmacy in the UK

OBJECTIVES: The Department of Health in England developed the 'You're Welcome' framework, comprising criteria for all health services seeing 11- to 19-year olds, to improve their quality and coverage and reduce access inequities. To date, however, the 'You're Welcome' criteria have not been considered within community pharmacy service development policy. The aim of this article was to assess the relevance of the 'You're Welcome' criteria to community pharmacy, and examine ways in which they are currently met, or not met, to guide future service development. METHODS: The project employed three methods. Checklist-guided observations and face-to-face semistructured interviews with staff members were undertaken in eight community pharmacies across England and Scotland, purposively selected because of their known focus on provision of young people's services. This was complemented by a cross-sectional online survey for completion by pharmacy staff across a wider range of pharmacies recruited through targeted Local Pharmaceutical Committees (LPC). Study instruments were designed to gather information relevant to each of the 'You're Welcome' criteria. KEY FINDINGS: Eight pharmacies took part in observations and interviews. Six LPCs posted the online survey link on their website, which was returned by 56 respondents. The results demonstrate applicability of the 'You're Welcome' criteria to community pharmacy services, highlighting particular strengths of community pharmacy services for young people (e.g. accessibility) as well as opportunities and priorities for service development to meet their specific needs (e.g. staff training, engagement and integration with local service provision). CONCLUSIONS: The 'You're Welcome' criteria can be applied to community pharmacy services without adaptation providing an appropriate framework to guide service development to promote young people friendly pharmacy services. JPHS

Patients' management of type 2 diabetes in Middle Eastern countries: review of studies

The increased prevalence of diabetes in Middle Eastern countries is a health policy priority. Important risk factors for diabetes have been identified. Lifestyle interventions and adherence to medications are central to disease prevention and management. This review focuses on the management of type 2 diabetes mellitus in Middle Eastern countries. The aim is to identify the ways in which knowledge, health beliefs, and social and cultural factors influence adherence to medication and lifestyle measures. Thirty-four studies were identified following a systematic search of the literature. The studies describe the influence of knowledge, health beliefs, culture, and lifestyle on the management of type 2 diabetes mellitus in the Middle East. Findings indicate a lack of health knowledge about diabetes among populations, which has implications for health behaviors, medication adherence, and treatment outcomes. Many identified health beliefs and cultural lifestyle factors, such as religious beliefs, beliefs about fasting during Ramadan, and sedentary lifestyles played a role in patients’ decisions. For better management of this disease, a collaborative approach between patients, their families, health care professionals, and governments should be adopted. Implementing behavioral strategies and psychological interventions that incorporate all health care professionals in the management process have been shown to be effective methods. Such services help patients change their behavior. However, the utilization of such services and interventions is still limited in Arabian countries. Physicians in the Middle East are the health care professionals most involved in the care process

Challenges to optimal medicines use in people living with dementia and their caregivers: A literature review

Dementia is fast becoming a global concern due to a demographic shift towards an older population. Many studies have shown that caring for a family member or friend has a profound and negative impact on the physical, emotional and psychosocial aspects of the caregivers’ life. One significant activity that a family caregiver undertakes is assistance with the management of medicines. This review was undertaken to ascertain what the issues are that affect optimal medicines use from the perspectives of people living with dementia and their caregivers, both in the community and care home settings. A literature search was conducted using electronic databases, employing a combination of search terms. A total of 16 studies met the inclusion criteria. Six broad themes were identified, together with some recommendations to improve medicines use in people with dementia. Challenges to medicines use centred on medicines management and administration, the impact on the caregiver and care recipient, their partnership and interface with formal care. Future research should focus on developing targeted interventions that can overcome these challenges to achieve optimal medicines use